Perelló Maria, Martínez-Zamora Maria A, Torres Ximena, Munrós Jordina, Llecha Silvia, De Lazzari Elisa, Balasch Juan, Carmona Francisco
Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
CRESIB (Barcelona Center for International Health Research), Hospital Clínic, Barcelona, Spain.
Eur J Obstet Gynecol Reprod Biol. 2017 Feb;209:55-60. doi: 10.1016/j.ejogrb.2015.11.024. Epub 2015 Nov 26.
The purpose of the study was to develop an easily applicable predictive model to predict deep infiltrating endometriosis in patients with ovarian endometrioma.
We performed a retrospective analysis of 178 consecutive women with ovarian endometrioma who underwent surgery, with histological confirmation and complete removal of endometriosis in the Hospital Clinic of Barcelona. Several markers were prospectively obtained and compared between the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma and women with only ovarian endometrioma. Multiple logistic regression analysis was performed to create a model to predict the presence of deep infiltrating endometriosis and internal validation was later performed.
Of the 178 patients studied, 80 (45%) were classified in the ovarian endometrioma group and 98 (55%) in the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma. The independent variables to predict deep infiltrating endometriosis were: at least one previous pregnancy, a past history of surgery for endometriosis and the mean endometriosis-associated pelvic pain score. The area under the ROC curve was 0.91 (95% confidence interval: 0.86-0.94), with an optimal cut-off of the predicted probability of 0.54. The sensitivity of the model was 80% and the specificity 84%.
This model predicts the development of deep infiltrating endometriosis in patients with ovarian endometriomas allowing prioritization of women for referral to specialized centers.
本研究旨在开发一种易于应用的预测模型，以预测卵巢子宫内膜异位囊肿患者的深部浸润性子宫内膜异位症。
我们对巴塞罗那医院诊所连续178例行手术治疗的卵巢子宫内膜异位囊肿女性患者进行了回顾性分析，这些患者的子宫内膜异位症经组织学证实且已完全切除。前瞻性获取了多个标志物，并对伴有卵巢子宫内膜异位囊肿的深部浸润性子宫内膜异位症患者组与仅患有卵巢子宫内膜异位囊肿的女性患者组进行了比较。进行了多因素逻辑回归分析以创建一个预测深部浸润性子宫内膜异位症存在的模型，随后进行了内部验证。
在研究的178例患者中，80例（45%）被归类为卵巢子宫内膜异位囊肿组，98例（55%）被归类为伴有卵巢子宫内膜异位囊肿的深部浸润性子宫内膜异位症患者组。预测深部浸润性子宫内膜异位症的独立变量为：至少有一次既往妊娠、子宫内膜异位症手术史以及与子宫内膜异位症相关的平均盆腔疼痛评分。ROC曲线下面积为0.91（95%置信区间：0.86 - 0.94），预测概率的最佳截断值为0.54。该模型的敏感性为80%，特异性为84%。
该模型可预测卵巢子宫内膜异位囊肿患者深部浸润性子宫内膜异位症的发生，有助于对女性患者进行优先排序，以便转诊至专科中心。
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