| Purpose:Objective to investigate the relationship between the expression of BDNF、 NLR and CA125 in serum of endometriosis patients and the degree of dysmenorrhea and clinical stage of endometriosis,and the diagnostic value of BDNF、NLR and CA125 in endometriosis.Methods:150 patients with endometriosis who were admitted to the Department of gynaecology of the people’s Hospital of Xinjiang Uygur Autonomous Region from October 2019 to October 2020 were selected as the study group.According to the standard staging(AFS)revised by American Fertility Association,all patients were divided into stage I、II、III and IV;according to the presence or absence of dysmenorrhea,they were divided into two groups,and the dysmenorrhea group was divided into three groups according to the visual analogue scale(VAS): mild pain group、moderate pain group and severe pain group.Two groups of controls were set up,one was the patients with benign ovarian cysts diagnosed as non endometriosis by pathology in the same period,the other was the healthy women who received physical examination in the physical examination center of our hospital in the same period.Fasting venous blood was collected from all the subjects,blood routine and CA125 were detected,NLR was calculated according to the ratio of neutrophils to lymphocytes,and the expression of BDNF in serum was detected by ELISA;the differences of dysmenorrhea degree and clinical stages among the three groups were analyzed,and the sensitivity and specificity of the three indicators were analyzed by drawing ROC curve,so as to find the best cut-off Objective to evaluate the diagnostic value in endometriosis.Results:1.The expression levels of BDNF、NLR and CA125 in serum of EMs patients were significantly higher than those in benign ovarian cyst group and healthy women group(P< 0.001);2.The levels of BDNF、NLR and CA125 in serum of patients with different clinical stages of EMs were significantly different(P<0.001),and the levels of BDNF、NLR and CA125 increased with the increase of the stage level of EMs group;3.The level of BDNF was significantly higher in moderate and severe pain group than in mild pain group(P<0.001).However,the levels of NLR and CA125 were not significantly different in non dysmenorrhea and EMs patients with different pain degrees(P>0.05);4.BDNF、NLR and CA125 were positively correlated with the severity of EMs(r = 0.789,r = 0.357,r= 0.383,P< 0.001);5.When diagnosing EMs with single index:The sensitivity of BDNF was 76.7%,specificity was92.0%,area under curve was 0.885;the sensitivity of NLR was 48.0%,specificity was 81.7%,area under curve was 0.664;the sensitivity of CA125 was 86.0%,specificity was 77.7%,area under curve was 0.891;6.When multiple indicators were combined to diagnose EMs:The sensitivity and specificity of BDNF and NLR combined diagnosis for EMs were 76.0%,90.7%,and the area under curve was 0.895;The sensitivity and specificity of NLR and CA125 combined with EMs were 78.7%,87%,and the area under curve was 0.892;The sensitivity and specificity of BDNF and CA125 combined diagnosis for EMs were81.3%,96.7%,and the area under curve was 0.933;The sensitivity and specificity of BDNF、NLR and CA125 combined diagnosis for EMs were 77.3%,98.7%,and the area under curve was 0.936.Conclusion:1.The expression of BDNF、NLR and CA125 in serum of patients with EMs was significantly increased,which was closely related to EMs,and could be gradually increased with the progression of EMs stage,suggesting that BDNF、NLR and CA125 could be used as a good indicator of disease progression and severity;2.The expression of BDNF in serum of EMs patients with dysmenorrhea was significantly increased,and it was positively correlated with the degree of dysmenorrhea;3.The diagnostic value of BDNF and CA125 in serum alone is better than that of NLR in the diagnosis of EMs.When they are combined,they can obtain higher diagnostic value and can be used as serological diagnostic markers for predicting and diagnosing EMs. |
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