Jiang Caixia, Liu Chao, Guo Jing, Chen Li, Luo Ning, Qu Xiaoyan, Yang Weihong, Ren Qing, Cheng Zhongping
Department of Gynecology and Obstetrics, Yangpu Hospital, Tongji University School of Medicine Department of Gynecology and Obstetrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Institute of Gynecological Minimal Invasive Medicine, Tongji University School of Medicine, Shanghai, China.
Medicine (Baltimore). 2017 May;96(19):e6880. doi: 10.1097/MD.0000000000006880.
To explore the value of serum levels of CA125, platelet count (PLT), neutrophil-lymphocyte ratio (NLR), and modified CA125 markers CA125a and CA125b in predicting pelvic dense adhesion (PDA) associated with adenomyosis, CA125a = lg(CA125 × PLT × 10), CA125b = lg(CA125 × NLR).This retrospective study included 304 patients who underwent surgery for adenomyosis. Correlations of serum levels of CA125, PLT, NLR, and modified CA125 markers with adenomyosis-derived PDA were analyzed by Logistic regression. Receiver operating characteristic curve was applied to assess the utility of these parameters for predicting PDA.All the parameters including CA125, PLT, NLR, and modified CA125 markers were positively correlated with PDA (P < .05 or P < .01). More importantly, CA125a was more specific (85.03% vs. 83.00%) and more sensitive (47.56% vs. 47.47%) than CA125 alone for the prediction of PDA, and CA125b could also improve the predictive specificity of PDA (53.13% vs. 47.47%).Serum CA125, PLT, and NLR were all closely correlated with PDA in adenomyosis patients. CA125 modified by PLT and NLR could further improve the predictive accuracy of adenomyosis-derived PDA, thus providing more meaningful references for better-informed decisions about the mode of surgical access for the clinical treatment of adenomyosis.
为探讨血清CA125水平、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)以及改良CA125标志物CA125a和CA125b在预测子宫腺肌病相关盆腔致密粘连(PDA)中的价值,CA125a = lg(CA125×PLT×10),CA125b = lg(CA125×NLR)。这项回顾性研究纳入了304例行子宫腺肌病手术的患者。采用Logistic回归分析血清CA125、PLT、NLR和改良CA125标志物水平与子宫腺肌病源性PDA的相关性。应用受试者工作特征曲线评估这些参数预测PDA的效用。所有参数包括CA125、PLT、NLR和改良CA125标志物均与PDA呈正相关(P < 0.05或P < 0.01)。更重要的是,在预测PDA方面,CA125a比单独的CA125更具特异性(85.03%对83.00%)和敏感性(47.56%对47.47%),并且CA125b也能提高PDA的预测特异性(53.13%对47.47%)。血清CA125、PLT和NLR均与子宫腺肌病患者的PDA密切相关。经PLT和NLR改良的CA125可进一步提高子宫腺肌病源性PDA的预测准确性,从而为子宫腺肌病临床治疗手术入路方式的明智决策提供更有意义的参考。