| 王 媛,冯 晓,牟孙凡,李 倩,周晓莹.经阴道超声联合血清AFP、PAI-1及MMIF对子宫内膜异位症的诊断价值分析[J].,2024,(10):1955-1959 |
| 经阴道超声联合血清AFP、PAI-1及MMIF对子宫内膜异位症的诊断价值分析 |
| Analysis of the Diagnostic Value of Transvaginal Ultrasound Combined with Serum AFP, PAI-1, and MMIF in Endometriosis |
| 投稿时间：2023-10-08 修订日期：2023-10-30 |
| DOI：10.13241/j.cnki.pmb.2024.10.032 |
| 中文关键词: 经阴道超声 甲胎蛋白 纤溶酶原激活物抑制物1 巨噬细胞移动抑制因子 灵敏度 特异度 |
| 英文关键词: Transvaginal ultrasound Alpha fetoprotein Plasminogen activator inhibitor 1 Macrophage migration inhibitory factor Sensitivity Specificity |
| 基金项目:陕西省自然科学基础研究计划项目（2020JQ-953） |
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| 中文摘要: |
| 摘要 目的：探讨经阴道超声联合血清甲胎蛋白（AFP）、纤溶酶原激活物抑制物1（PAI-1）及巨噬细胞移动抑制因子（MMIF）对子宫内膜异位症的诊断价值。方法：选取我院2021年8月到2023年8月收治的150例子宫内膜异位症患者进行回顾性分析，分析其经阴道超声检查图像特征，并以病理诊断作为"金标准"，分析阴道超声对宫内膜异位症的阳性检出率。依照子宫内膜异位症分期，将其分为Ⅰ~Ⅱ期组（n=77），Ⅲ~Ⅳ期组（n=73），另选取同期来我院体检的150例健康女性作为对照组。分析三组受检者血清AFP、PAI-1及MMIF表达水平，并采用Spearman相关分析法分析AFP、PAI-1及MMIF与子宫内膜异位症的相关性。最后建立受试者特征（ROC）工作曲线分析经阴道超声联合血清AFP、PAI-1及MMIF对子宫内膜异位症的诊断效能。结果：150例子宫内膜异位症患者均经病理诊断确诊，通过经阴道超声检查确诊为子宫内膜异位症的患者128例，85.33%。其中75例患者为卵巢型，超声显示巨大巧克力囊肿，内部可见大量细密点状回声与分隔光带。53例患者为子宫型，超声显示后壁腺肌瘤，内部回声不均匀，可见片状无回声区域；三组受检者血清AFP、PAI-1及MMIF表达水平对比差异显著，Ⅲ~Ⅳ期组明显高于Ⅰ~Ⅱ期组和对照组，差异具有统计学意义（P＜0.05）；Spearman相关分析结果显示：AFP、PAI-1及MMIF与子宫内膜异位症呈正相关（P＜0.05）；诊断灵敏度和特异度从低到高依次为MMIF（52.58%、64.32%）、PAI-1（60.03%、67.53%）、AFP（65.24%、71.27%）、经阴道超声（73.25%、86.36%）、经阴道超声联合血清AFP、PAI-1及MMIF（84.26%、98.63%）。经阴道超声联合血清AFP、PAI-1及MMIF的诊断灵敏度明显高于单一指标诊断（P＜0.05）。结论：经阴道超声联合血清AFP、PAI-1及MMIF对子宫内膜异位症的诊断价值较高，其灵敏度和特异度分别为84.26%、98.63%，通过联合诊断可进一步辅助减少子宫内膜异位症的误诊和漏诊几率，为子宫内膜异位症的诊断与治疗提供重要参考。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the diagnostic value of transvaginal ultrasound combined with serum alpha fetoprotein (AFP), plasminogen activator inhibitor-1 (PAI-1), and macrophage migration inhibitory factor (MMIF) in endometriosis. Methods: A retrospective analysis was conducted on 150 patients with endometriosis admitted to our hospital from August 2021 to August 2023. The imaging features of transvaginal ultrasound were analyzed, and pathological diagnosis was used as the "gold standard" to analyze the positive detection rate of vaginal ultrasound for endometriosis. According to the staging of endometriosis, it was divided into stage I-II group (n=77) and stage III-IV group (n=73). In addition, 150 healthy women who came to our hospital for physical examination during the same period were selected as the control group. Analyze the expression levels of serum AFP, PAI-1, and MMIF in three groups of subjects, and use Spearman correlation analysis to analyze the correlation between AFP, PAI-1, and MMIF and endometriosis. Finally, a receiver characteristics (ROC) working curve was established to analyze the diagnostic efficacy of transvaginal ultrasound combined with serum AFP, PAI-1, and MMIF for endometriosis. Results: All 150 patients with endometriosis were diagnosed by pathology, and 128 patients (85.33%) were diagnosed with endometriosis through transvaginal ultrasound examination. Among them, 75 patients were ovarian type, and ultrasound showed a huge chocolate cyst with a large amount of fine dotted echoes and separated light bands inside. 53 patients were of uterine type, and ultrasound showed a posterior wall adenomyoma with uneven internal echoes and visible patchy anechoic areas; There were significant differences in the expression levels of serum AFP, PAI-1, and MMIF among the three groups of subjects. The levels of serum AFP, PAI-1, and MMIF in the stage III-IV group were significantly higher than those in the stage I-II group and the control group, and the difference was statistically significant(P<0.05); Spearman correlation analysis showed that AFP, PAI-1, and MMIF were positively correlated with endometriosis(P<0.05); The diagnostic sensitivity and specificity from low to high were MMIF(52.58%, 64.32%), PAI-1 (60.03%, 67.53%), AFP (65.24%, 71.27%), transvaginal ultrasound (73.25%, 86.36%), transvaginal ultrasound combined with serum AFP, PAI-1, and MMIF (84.26%, 98.63%). The diagnostic sensitivity of transvaginal ultrasound combined with serum AFP, PAI-1, and MMIF was significantly higher than that of single indicator diagnosis(P<0.05). Conclusion: Transvaginal ultrasound combined with serum AFP, PAI-1, and MMIF has a high diagnostic value for endometriosis, with sensitivity and specificity of 84.26% and 98.63%, respectively. Through combined diagnosis, it can further assist in reducing the probability of misdiagnosis and missed diagnosis of endometriosis, providing important reference for the diagnosis and treatment of endometriosis. |
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