Changes And Clinical Value Of Inflammatory Parameters,Coagulation Parameters And CA125 In Patients With Endometriosis

BackgroundEndometriosis is not only an estrogen-dependent disease,but also an inflammatory disease or hemorrhagic disease.In recent years,studies at home and abroad have found that inflammation and coagulation may be related to the occurrence and development of endometriosis.Therefore,in this paper,we analyzed the changes of CA125,coagulation parameters and inflammatory parameters in patients with endometriosis and explored their relationship with the severity of the disease to deepen the understanding of the underlying pathogenesis and pathophysiological mechanism,find potential therapeutic targets,and provide reliable clinical evidence for basic research.ObjectiveBy analyzing and comparing the differences of coagulation and inflammation parameters and CA125 between endometriosis group and non-endometriosis group,and differences between subgroups of endometriosis patients,to analyze the clinical significance and value of the above indicators.MethodThe data of 306 patients(endometriosis group)who were treated and diagnosed with endometriosis by open surgery or laparoscopic surgery in the Department of Gynecology of Shenzhen Hospital of Peking University from September 2019 to September 2021 were analyzed retrospectively,and the data of 129 patients who were treated and diagnosed with benign ovarian cyst(non-endometriosis group)in the same period were collected.The endometriosis group was divided into groups according to the staging method of endometriosis revised by the American Fertility Society(AFS)in 1997,the evaluation standard of pelvic adhesion in Peking Union Medical College Hospital,and the severity of adhesion of the Douglas pouch.The differences of coagulation and inflammation parameters and CA125 between these groups were analyzed and compared.ResultsSerum CA125 [49.75(27.56 ～ 81.55)U/m L] in patients with stage Ⅲ-Ⅳendometriosis was significantly higher than that in patients with stage Ⅰ-Ⅱendometriosis(P < 0.001).The serum CA125 of patients with ovarian chocolate cyst group and benign ovarian tumor group were 49(27.5 ～ 81)U / m L and 17.4(12.1 ～23.9)U / m L,respectively.The diagnostic cut off value of CA125 in the diagnosis of ovarian chocolate cyst was 30.45U/m L.NLR,PLR and FIB in patients with moderate to severe pelvic adhesion [1.96(1.36～ 2.52),140.69(111.31 ～ 181.09)and 2.86(2.49 ～ 3.18)g / L respectively] were significantly higher than those in patients with no or mild pelvic adhesion [1.63(1.31～ 2.22),125.23(105.90 ～ 158.68)and 2.59(2.33 ～ 2.96)g / L respectively];(P <0.05),while TT was lower(P < 0.05).The levels of serum CA125 and FIB in patients with complete disappearance of Douglas pouch were significantly higher than those in patients without complete disappearance of Douglas pouch(P < 0.05).FIB was significantly positively correlated with the degree of pelvic adhesion and the severity of Douglas pouch adhesion.The area under the curve(AUC)of CA125 *FIB in the diagnosis of moderate and severe pelvic adhesion in endometriosis was 0.660 and the sensitivity was 64.3%.ConclusionThis study found that CA125 has significant value in the diagnosis of ovarian endometriosis cyst,and its diagnostic cut off value is 30.45U/m L.CA125 was significantly increased in patients with stage Ⅲ-Ⅳ,moderate and severe pelvic adhesion and total disappearance of Douglas pouch.FIB in patients with total disappearance of Douglas pouch was significantly higher.FIB,NLR and PLR in patients with moderate and severe pelvic adhesion were significantly higher than those in the no or mild adhesion group,suggesting coagulation and inflammation are both involved in the occurrence and development of pelvic adhesion.The combined index CA125 * FIB helps with the diagnosis of moderate and severe pelvic adhesions in endometriosis.In conclusion,CA125,coagulation parameters and inflammation parameters have clinical significance in predicting the condition of patients with endometriosis and evaluating the difficulty of surgery,suggesting that coagulation and inflammation are potential therapeutic targets of endometriosis.