| Objective:By retrospectively analyzing the basic clinical data,coagulation factors,inflammatory factors and CA125 of patients with moderate and severe ovarian endometriosis,to explore the clinical predictive value of preoperative coagulation and inflammatory factors in patients with moderate and severe ovarian endometriosis,in order to provide a new reference for the diagnosis of patients with endometriosis.Methods:A retrospective analysis of 145 patients with ovarian endometriosis（endometriosis group）who underwent inpatient surgery at the First Hospital of Jilin University from January 2019 to December 2020 was selected.The preoperative basic clinical data of 116 patients with benign ovarian cysts confirmed by pathology（non-endometriosis group）,including age,height,weight,pregnancy,parity and number of miscarriages;coagulation and inflammatory factors:thrombin time（TT）,activated partial prothrombin time（APTT）,prothrombin time（PT）,fibrinogen（FBG）,platelets（PLT）;percentage of neutrophils（NEUT%）,percentage of lymphocytes（LY%）,Percent monocytes（MO%）,percent eosinophils（EO%）,absolute neutrophils（NEUT#）,absolute lymphocytes（LY#）,absolute monocytes（MO#）,medium neutrophil-to-lymphocyte ratio（NLR）,monocyte-to-lymphocyte ratio（MLR）,platelet-tolymphocyte ratio（PLR）,systemic immune inflammatory index [SII=（platelet count×neutrophil count）/Lymphocyte count],systemic inflammatory response index [SIRI=（neutrophil count × monocyte count）/lymphocyte count] and oncological marker serum CA125,etc.,using SPSS24.0 for statistical analysis,To analyze the differences of preoperative coagulation,inflammatory factors and serum CA125 levels in patients with ovarian endometriosis and ovarian cysts,analyze the correlation between coagulation and inflammatory factors in patients with ovarian endometriosis,and explore the preoperative The predictive value of coagulation and inflammatory factors on the onset of ovarian endometriosis,and the ROC curve was drawn to calculate the sensitivity,specificity and optimal diagnostic threshold.Results:（1）The average surgical age of patients in the endometriosis group was greater than that in the non-endometriosis group,and the difference was statistically significant（P<0.05）;however,there was no significant difference in BMI,pregnancy,parity,and number of miscarriages between the two groups（P>0.05）.（2）The TT in the endometriosis group was shorter than that in the non-endometriosis group,and the difference was statistically significant（P<0.001）;the PT was higher than that in the non-endometriosis group,and the difference was statistically significant（P<0.05）;There was no significant difference in FBG and PLT between the two groups（P>0.05）,but the level of FBG in the endometriosis group was higher than that in the non-endometriosis group.（3）The levels of NEUT#,NEUT%,PLR,NLR,and SII in the endometriosis group were higher than those in the non-endometriosis group,and the difference was statistically significant（P<0.05）.LY#,LY%,MO%,EO% The level was lower than that of the nonendometriosis group,and the difference was statistically significant（P<0.05）.There was no significant difference in MO#,MLR and SIRI between the two groups（P>0.05）.The serum CA125 level in the endometriosis group was higher than that in the non-endometriosis group,and the difference was statistically significant（P<0.001）.（4）The TT of patients with endometriosis IV was shorter than that of patients with endometriosis III,and the difference was statistically significant（P<0.05）.There was no significant difference in APTT,PT,FBG,and PLT in patients with schizophrenia（P>0.05）.（5）The level of CA125 in patients with endometriosis IV was significantly higher than that in patients with endometriosis III,and its level increased with the stage of endometriosis,and the difference was statistically significant（P=0.001）.NEUT%,LY%,EO%,NEUT#,LY#,MO#,NLR,MLR,PLR,SII,SIRI,the difference was not statistically significant（P>0.05）.MO%（P=0.05）.（6）In the endometriosis group,TT was negatively correlated with NEUT%（P=0.007）,positively correlated with LY%（P=0.043）,positively correlated with MO%（P<0.001）,and negatively correlated with NEUT#（P=0.014）,negatively correlated with NLR（P=0.023）,and negatively correlated with SII（P=0.047）.（7）NLR and CA125 were risk factors for the onset of endometriosis,and were positively correlated with the onset of endometriosis.TT was a risk factor for the onset of endometriosis,and negatively correlated with the onset of endometriosis.（8）The best diagnostic cut-off value of TT was 16.550,the sensitivity was 0.983,and the specificity was 0.428;the best diagnostic cut-off value of CA125 was 25.125,the sensitivity was 0.910,and the specificity was 0.828;the best diagnostic cut-off value of NLR was 2.351,the sensitivity was 0.469,and the specificity was 0.733.（9）The AUC of combination 1=0.937,95%CI [0.909-0.965],the sensitivity is 0.862,and the specificity is 0.897;the AUC of combination 2 is 0.947,95%CI [0.923-0.971],the sensitivity is 0.862,and the specificity is 0.862.was 0.888;the AUC of combination 3 was0.950,95%CI [0.927-0.973],the sensitivity was 0.862,and the specificity was 0.922.Conclusion:（1）Patients with endometriosis may have a relatively hypercoagulable state and inflammatory response,and the detection of coagulation and inflammatory factors may have certain guiding significance for the diagnosis of patients with moderate to severe ovarian endometriosis.（2）As a simple and easy-to-obtain serum marker,NLR may have certain predictive value for the onset of moderate-to-severe ovarian endometriosis.（3）CA125 can assist in the diagnosis of moderate to severe ovarian endometriosis with high sensitivity and specificity.（4）TT can reflect the coagulation state of patients with moderate-to-severe ovarian endometriosis,and its level decreases with the increase of the stage,which has a certain predictive value for the onset of moderate-to-severe ovarian endometriosis.（5）There is a certain degree of interaction between the coagulation system and the inflammatory system in patients with endometriosis,which is related to the occurrence and development of endometriosis to some extent.（6）Compared with serum CA125 alone in the diagnosis of endometriosis,serum CA125 combined with NLR,TT and the three have higher predictive value in the diagnosis of ovarian endometriosis. |
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