Miao Si Yan, Wu Wen Rui, Feng Liang, Chen Qiang
Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, CHN.
Cureus. 2024 Sep 24;16(9):e70072. doi: 10.7759/cureus.70072. eCollection 2024 Sep.
Most patients with VC have no symptoms, so they are often discovered due to male infertility. Early identification of them is a matter of concern for clinicians. A retrospective analysis of clinical data from patients between January 1, 2021, and February 1, 2024, was conducted. Patients were divided into VC and non-VC groups. Propensity score matching (PSM) was performed at a ratio of 1:1, and two cohorts with homogeneous baseline status were selected. Multivariate binary logistic regression and receiver operating characteristic (ROC) curve were used to analyze independent risk factors and protective factors and to evaluate their diagnostic value individually and in combination. A p-value <0.05 was considered statistically significant. A total of 256 patients with similar clinical characteristics were further analyzed after PSM in a 1:1 ratio of the 423 patients included in the study. The two groups had statistically significant differences in systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and body mass index (BMI) (p<0.05). Multivariate binary logistic regression analysis showed that SII and NLR were independent risk factors for VC, while high BMI could reduce the prevalence of VC. The PLR differences were not significant. The ROC analysis showed that BMI, SII, and NLR could predict VC, with areas under the curve of 68.3% (cut-off value 22.32), 83.4% (cut-off value 357.57), and 83.2% (cut-off value 1.8), respectively. The combination of BMI and inflammatory factors was more accurate for predicting VC than BMI alone (87.5% vs. 68.3%, p=0.0001), SII (87.5% vs. 83.4%, p=0.0106), and NLR (87.5% vs 83.2%, p=0.0058). Both SII and NLR are independent risk factors for VC while BMI is an independent protective factor. The BMI, SII, and NLR values have the potential to predict VC. The BMI combined with these inflammatory factors can improve the accuracy of prediction.
大多数精索静脉曲张（VC）患者没有症状，因此他们常常因男性不育而被发现。对他们的早期识别是临床医生关注的问题。对2021年1月1日至2024年2月1日期间患者的临床资料进行了回顾性分析。患者被分为VC组和非VC组。以1:1的比例进行倾向得分匹配（PSM），选择了两个基线状态同质的队列。采用多变量二元逻辑回归和受试者工作特征（ROC）曲线分析独立危险因素和保护因素，并分别和联合评估它们的诊断价值。p值<0.05被认为具有统计学意义。在研究纳入的423例患者中，以1:1的比例进行PSM后，对256例具有相似临床特征的患者进行了进一步分析。两组在全身免疫炎症指数（SII）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和体重指数（BMI）方面存在统计学显著差异（p<0.05）。多变量二元逻辑回归分析表明，SII和NLR是VC的独立危险因素，而高BMI可降低VC的患病率。PLR差异不显著。ROC分析表明，BMI、SII和NLR可预测VC，曲线下面积分别为68.3%（临界值22.32）、83.4%（临界值357.57）和83.2%（临界值1.
