血清VCAM-1､PAI-1水平对子宫内膜异位症患者腹腔镜手术治疗预后的影响

目的分析血清血管细胞黏附分子-1(VCAM-1)?纤溶酶原激活物抑制因子-1(PAI-1)水平对子宫内膜异位症(EMs)患者腹腔镜手术治疗预后的影响。方法回顾性分析2017年2月至2021年2月渭南市妇幼保健院收治的43例行腹腔镜手术治疗预后不良的EMs患者的临床资料,设为不良组。另回顾性分析同期行腹腔镜手术治疗预后良好的43例EMs患者的临床资料,设为良好组。所有患者的临床资料均完整,包括一般资料及实验室检查资料,设计基线资料填写表,详细填写两组的基线资料,重点分析术前血清VCAM-1?PAI-1水平对EMs患者腹腔镜手术治疗预后的影响。结果不良组血清VCAM-1?PAI-1?癌抗原125(CA125)水平高于良好组,差异具有统计学意义(P<0.05);回归分析结果显示,EMs患者腹腔镜手术治疗前血清VCAM-1?PAI-1?CA125异常表达与预后有关,三者过表达可能是EMs患者腹腔镜手术治疗预后不良的风险因子(OR>1,P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,治疗前血清VCAM-1?PAI-1水平预测EMs患者腹腔镜手术治疗预后不良风险的曲线下面积(AUC)均>0.80,预测价值较为理想。结论EMs患者术前血清VCAM-1?PAI-1水平可能与腹腔镜手术治疗预后有关,两者低表达可能提示EMs患者腹腔镜手术治疗预后不良高风险。

The effect of serum VCAM-1 and PAI-1 levels on the prognosis of laparoscopic surgery in patients with endometriosis

Objective To analyze the effect of serum vascular cell adhesion molecule-1(VCAM-1)and plasminogen activator inhibitor-1(PAI-1)levels on the prognosis of laparoscopic surgery in patients with endometriosis(EMs).Methods The clinical data of 43 EMs patients with poor prognosis treated by laparoscopic surgery in Weinan Maternity and Child Health Hospital from February 2017 to February 2021 were retrospectively analyzed,and they were enrolled into the adverse group.The clinical data of 43 EMs patients with good prognosis who underwent laparoscopic surgery at the same time were enrolled into the good group.The clinical data of all patients were complete,including general data and laboratory examination data.A baseline data filling form was designed to fill in the baseline data of the two groups in detail,focusing on the analysis of the influence of preoperative serum VCAM-1 and PAI-1 levels on the prognosis of EMs patients undergoing laparoscopic surgery.Results The levels of serum VCAM-1,PAI-1 and cancer antigen 125(CA125)in the adverse group were higher than those in good group(P<0.05).Regression analysis showed that abnormal expression of serum VCAM-1,PAI-1 and CA125 was related to prognosis in patients with EMs before laparoscopic surgery,and overexpression of the three may be a risk factor for poor prognosis in patients with EMs(OR>1,P<0.05).The receiver operating characteristic(ROC)curve was plotted,and the results showed that the area under the curve(AUC)of serum VCAM-1 and PAI-1 levels before treatment for predicting the risk of poor prognosis in EMs patients was greater than 0.80,indicating a relatively ideal predictive value.Conclusions The serum VCAM-1 and PAI-1 levels may be related to the prognosis of laparoscopic surgery in EMs patients before operation,the low expression of the two may indicate the high risk of poor prognosis of EMs patients with laparoscopic surgery.