Yang Fanchun, Wang Qingying, Ma Rui, Deng Fangzhen, Liu Jie
Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
J Multidiscip Healthc. 2024 Jan 16;17:251-261. doi: 10.2147/JMDH.S435365. eCollection 2024.
Adenomyosis patients are in a hypercoagulable state, and studies have shown that carbohydrate antigen125 (CA125) may relate to the hypercoagulability and thrombosis of patients with adenomyosis, but there is still a lack of clarity regarding the changes in CA125-related coagulation indicators. This study was to explore the changes and influencing factors of CA125-related coagulation parameters in patients with adenomyosis.
Retrospective observational study conducted on 200 patients with adenomyosis (AM group), 240 patients with uterine leiomyoma (LM group) and 81 patients with cervical intraepithelial neoplasia (CIN)-III (control group), of which the coagulation parameters were detected by clinical blood sample collection and statistical method analysis and informed consent was obtained.
The level of CA125 in the AM group was significantly higher than that in the LM group and control group. However, thrombin time (TT) shortened in the AM group when compared with the LM and control group. Activated partial thromboplastin time (APTT) in the AM group was shorter than in the control group. Multivariate logistic regression analysis found that adenomyosis was associated with CA125 level (OR=323.860, 95% CI 90.424-1159.924, P<0.001), APTT (OR=1.295, 95% CI 1.050-1.598, P=0.016), TT (OR=0.642, 95% CI 0.439-0.938, P=0.022), menorrhagia (OR=7.363, 95% CI 2.544-21.315, P<0.001), dysmenorrhea (OR=22.590, 95% CI 8.185-62.347, P<0.001). Correlation analysis revealed that APTT (r= -0.207) and TT (r = -0.174) were negatively correlated with the level of CA125.
The shortening of CA125-related APTT and TT indicates that it is meaningful to detect coagulation parameters of patients with elevated CA125 levels early, dysmenorrhea and menorrhagia, and maybe further discover the hypercoagulability and prevent the occurrence of thrombus in adenomyosis.
子宫腺肌病患者处于高凝状态，研究表明糖类抗原125（CA125）可能与子宫腺肌病患者的高凝状态及血栓形成有关，但CA125相关凝血指标的变化仍不明确。本研究旨在探讨子宫腺肌病患者CA125相关凝血参数的变化及影响因素。
对200例子宫腺肌病患者（腺肌病组）、240例子宫肌瘤患者（肌瘤组）和81例宫颈上皮内瘤变III级患者（对照组）进行回顾性观察研究，通过采集临床血样检测凝血参数并进行统计学方法分析，且均获得知情同意。
腺肌病组CA125水平显著高于肌瘤组和对照组。然而，与肌瘤组和对照组相比，腺肌病组凝血酶时间（TT）缩短。腺肌病组活化部分凝血活酶时间（APTT）短于对照组。多因素logistic回归分析发现，子宫腺肌病与CA125水平（OR = 323.860，95%CI 90.424 - 1159.924，P < 0.001）、APTT（OR = 1.295，95%CI 1.050 - 1.598，P = 0.016）、TT（OR = 0.642，95%CI 0.439 - 0.938，P = 0.022）、月经过多（OR = 7.363，95%CI 2.544 - 21.315，P < 0.001）、痛经（OR = 22.590，95%CI 8.185 - 62.347，P < 0.001）有关。相关性分析显示，APTT（r = -0.207）和TT（r = -0.174）与CA125水平呈负相关。
CA125相关的APTT和TT缩短表明，早期检测CA125水平升高、痛经和月经过多患者的凝血参数具有意义，可能进一步发现高凝状态并预防子宫腺肌病中血栓的发生。
