Jing Xuanxuan, Li Chen, Sun Jintang, Peng Jin, Dou Yu, Xu Xiaofei, Ma Chao, Dong Zhaogang, Liu Yanguo, Zhang Hui, Shao Qianqian, Zhang Hui, Wang Lijie, Zhang Yun, Qu Xun
Institute of Basic Medical Sciences, Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital of Shandong University, Jinan, Shandong 250012, People's Republic China.
Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, People's Republic of China.
Ther Clin Risk Manag. 2020 May 11;16:403-412. doi: 10.2147/TCRM.S232849. eCollection 2020.
The aim of this study was to find the most useful marker of endometriosis-related infertility and evaluate predictive and diagnostic values of systemic inflammatory response markers (preoperative white blood-cell subtypes, neutrophil:lymphocyte ratio [NLR], platelet:lymphocyte ratio [PLR], and monocyte:lymphocyte ratio [MLR]) and CA125 levels in endometriosis patients.
This study comprised 662 women who had undergone laparoscopic surgery and been pathologically confirmed as having endometriosis and 83 patients pathologically confirmed with benign ovarian tumors. Related inflammatory factors in endometriosis complicated by infertility were analyzed via logistic regression analysis. Diagnostic values of the inflammatory response markers were obtained by receiver operating-characteristic analysis.
We firstly identified that lower NLR level was an independent risk factor of infertility. Serum lymphocytes were significantly higher in endometriosis patients, while serum CA125, NLR, MLR, and PLR were elevated. For differentiating endometriosis from other benign ovarian tumors, the combination of NLR and CA125 achieved greater sensitivity than CA125 alone. In addition, both CA125 and NLR were positively correlated with stage, oviduct adhesion, and diameter of ovarian ectopic cysts.
NLR may be used as a simple and easily obtained predictive marker for endometriosis with infertility. Moreover, NLR can be a neoadjuvant biomarker for serum CA125 to diagnose endometriosis.
本研究旨在寻找子宫内膜异位症相关性不孕最有用的标志物，并评估全身炎症反应标志物（术前白细胞亚型、中性粒细胞与淋巴细胞比值[NLR]、血小板与淋巴细胞比值[PLR]以及单核细胞与淋巴细胞比值[MLR]）和CA125水平在子宫内膜异位症患者中的预测和诊断价值。
本研究纳入662例行腹腔镜手术且经病理确诊为子宫内膜异位症的女性以及83例经病理确诊为良性卵巢肿瘤的患者。通过逻辑回归分析对子宫内膜异位症合并不孕患者的相关炎症因子进行分析。通过受试者工作特征分析获得炎症反应标志物的诊断价值。
我们首先确定较低的NLR水平是不孕的独立危险因素。子宫内膜异位症患者血清淋巴细胞显著升高，而血清CA125、NLR、MLR和PLR升高。对于鉴别子宫内膜异位症与其他良性卵巢肿瘤，NLR和CA125联合使用比单独使用CA125具有更高的敏感性。此外，CA125和NLR均与分期、输卵管粘连及卵巢异位囊肿直径呈正相关。
NLR可作为子宫内膜异位症伴不孕的一种简单易获取的预测标志物。此外，NLR可作为血清CA125诊断子宫内膜异位症的新辅助生物标志物。
