The Clinical Value Of Detection Of Coagulation And Inflammatory Factors In Endometriosis

Objective:By retrospectively analyzing medical records and postoperative follow-up data of endometriosis,we discussed preoperative coagulation and inflammatory factor levels for diagnostic value in endometriosis and prognostic value in patients with ovarian endometriosis,designing for the diagnosis of patients with endometriosis and poor prognosis of early detection and providing reference basis for the establishment of treatment.Methods:1.From October 2014 to October 2016,clinical data of 237 patients who accepted operation and confirmed by pathology for endometriosis(endometriosis group)and 110 patients who accepted operation and confirmed by pathology for other benign ovarian cysts(non-endometriosis group)in Northern Jiangsu People's Hospital were retrospectively analyzed.The coagulation and inflammatory factors were recorded:FIB,PT,TT,APTT,PT-INR,PLT,WBC,NE,LY,NLR,PLR and Tumor marker serum CA125.We used SPSS 19.0 software to analysis and discuss the diagnosis value of coagulation,inflammation factors and serum CA125 in endometriosis,and drawing the ROC curve,calculated the best diagnostic value,sensitivity,specific degrees.2.From October 2013 to October 2016,preoperative clinical data and postoperative follow-up data of 203 patients who accepted laparoscopic fertility preservation surgery and confirmed by pathology for ovarian endometriosis in Northern Jiangsu People's Hospital were retrospectively analyzed.We used SPSS 19.0 software to statistical analysis and discuss predictive value of various coagulation and inflammatory factors on postoperative recurrence and pregnancy in patients with ovarian endometriosis,and drawing the ROC curve,calculated the best predictive value,sensitivity,specific degrees.Result:1.The levels of the coagulation factor FIB in endometriosis group were significantly higher than in non-endometriosis group,the levels of inflammatory cytokines LY in endometriosis was significantly lower than the non-endometriosis group(P<0.01),The levels of the inflammatory factors NE,NLR and PLR in the endometriosis group were significantly higher than those in the non-endometriosis group(P<0.05).But there was no significantly statistical difference in PT,TT,APTT,PT-INR,PLT and WBC between the two groups;2.FIB,WBC,NE,NLR and serum CA125 were associated with the stage of endometriosis(P<0.05),and their levels increased with increase of stage.Although their levels of PLT and TT did not have statistical difference in stages,PLT also increased with the increase of stage,while TT decreased with the increase of stage;3.The diagnostic accuracy of serum CA125 for endometriosis was moderate(AUC=0.895),with a sensitivity of 71.7%and a specificity of 90.0%,the cut-off value of CA125 was 30.43U/ml However,the combination 3(CA125 �FIB�NLR)has a higher diagnostic value(AUC=0.925)than serum CA125,combination 1(CA125�FIB)and combination 2(CA125�NLR)in patients with endometriosis,with a sensitivity of 83.1%and a good specificity(86.4%),the cut-off value of 182.97,and the diagnostic value of combination 1 and combination 2 was not as high as CA125,but the sensitivity was higher than serum CA125;4.The diagnostic rate of NLR was higher than that of serum CA125 in early endometriosis(stage?+stage ?)(60.3%VS 41.4%),they have a statistical difference;5.203 patients with ovarian endometriosis performed fertility preservation surgery through laparoscopic.The recurrence rate within 1 year after surgery was 8.37%(17/203),and the recurrence rate within 2 years was 17.24%(35/203).The serum CA125 of patients with recurrence was higher than patients without recurrence within 2 year after surgery,showing a statistical difference(P<0.05),while there was no statistically significant difference between preoperative coagulation factors,inflammatory factors and postoperative recurrence;6.The natural pregnancy rate was 60.00%(42/70)within 1 year after surgery,and natural pregnancy rate was 67.14%(47/70)within 2 year after surgery.The PLT of non-pregnant patients was higher than that of pregnant patients within 1 year after surgery(P<0.05),and there was no statistically significant difference between preoperative coagulation factors,inflammatory factors and postoperative pregnancy(P>0.05).However,the predictive value of high level PLT in predicting postoperative pregnancy failure is low(AUC=0.675),and its cut-off value is 257.5�109/L,with a sensitivity and specificity of 64.3%and 71.4%respectively.Conclusion:1.Patients with endometriosis may have relativistic hypercoagulability and inflammatory responses,which are associated with the severity of endometriosis;2.The combination of serum CA125 with FIB and NLR is more valuable than serum CA125 in the diagnosis of endometriosis,which improves the sensitivity of diagnosis and has a good specificity;3.In early endometriosis(stage ?+stage ?),NLR is more valuable than serum CA125 in diagnosis;4.The coagulation and inflammatory factors have no predictive value for postoperative recurrence in patients with ovarian endometriosis;5.High level of PLT is a risk factor for postoperative pregnancy failure in patients with ovarian endometriosis,which has certain reference value in predicting pregnancy failure.