Clinical Significance Of CA125 Combined With Inflammatory Factors And Coagulation Indexes In Ovarian Endometriosis

Background: Endometriosis（EMT）is endometrial tissue（glands and stroma）that occurs outside the body of the uterus.Ectopic Endometriosis can invade any part of the body,including the peritoneum and pelvic organs.The ovaries and the uterine sacral ligaments are the most common and the most representative ones are ovarian Endometriosis.Endometriosis is a common gynecological disorder in women of childbearing age,affecting approximately 5% to 15% of women,with an increased incidence in recent years.Up to now,the pathogenesis has not been clear,and a large number of data studies have shown that the occurrence and development of endometriosis is correlated with abnormal changes in inflammatory factors and coagulation indicators.Endometriosis can cause progressive dysmenorrhea,chronic pelvic pain,sexual discomfort,excessive menstruation and infertility,and many other uncomfortable symptoms.Although pathologically classified as benign tumors,they have the habit of malignant tumor growth（invasion,recurrence,metastasis,etc.）and have a great impact on health-related quality of life（HRQo L）.It is generally accepted that the criteria for diagnosis of endometriosis are laparoscopy and histopathology.Preoperative diagnosis is difficult and there is a lack of sensitive and specific biological indicators in clinical diagnosis.Therefore,finding low invasive biomarkers is of great significance for the clinical diagnosis and treatment of EMs.Because ovaries are most susceptible to endometrial invasion by ectopic endometrium,ovarian endometrial cysts were used as the observation group.In this study,the clinical significance of glucose chain antigen 125（CA125）,inflammatory factors and coagulation indexes in the etiology and diagnosis of ovary was further explored.Objective:To investigate the clinical significance of CA125,inflammatory factors and coagulation indexes in ovarian endometriosis.Methods:A total of 111 cases of chocolate ovarian cyst treated in Chaohu Hospital affiliated to Anhui Medical University from June 2019 to February 2022 were selected as the experimental group,and 115 cases of non-chocolate ovarian benign tumor（non-chocolate ovarian cyst）were selected as the control group.The experimental group according to the American fertility society（AFS）grading method is divided into 11 patients with stage I ovarian endometriosis,29 patients with stage II ovarian endometriosis,35 patients with III ovarian endometriosis,36 patients with stage IV ovarian endometriosis.The clinical data of the two groups were statistically analyzed.Results:1)The levels of glucose chain antigen 125（CA125）,neutrophil count,neutrophil/lymphocyte count（NLR）,interleukin-6（IL-6）,D-dimer（D-D）and fibrinogen（FIB）in serum of patients with ovarian endometriosis were higher than those in control group,and the differences were statistically significant（P<0.05）.The serum lymphocyte count of patients with chocolate cyst of ovary was lower than that of control group and the difference was statistically significant（P<0.05）.There is a certain correlation between serum inflammatory factors and coagulation indexes in patients with ovarian endometriosis.In observation group,NLR was positively correlated with D-D（r=0.232,P=0.002）,negatively correlated with TT（R =-0.236,P<0.001）,and positively correlated with FIB（r=0.197,P=0.003）.In observation group,IL-6 was positively correlated with D-D（r=0.479,P=0.003）,negatively correlated with TT（r=-0.627,P=0.003）and positively correlated with FIB（r=0.398,P=0.015）.There was a positive correlation between serum IL-6 and NLR in two groups（r=0.546,P<0.001）.In the patients with ovarian endometriosis,FIB was positively correlated with D-D（r=0.315,P<0.001）,but negatively correlated with TT（r=-0.356,P<0.001）.There was a negative correlation between serum TT value and D-D value in patients with ovarian endometriosis（r=-0.255,P=0.001）.2)The score of ovarian endometriosis（AFS score）was positively correlated with D-D value in serum（r=0.265,P=0.010）,and with FIB value in serum（r=0.724,P<0.001）.There were statistically significant differences in serum D-D,FIB and TT values in patients with ovarian endometriosis at different stages（P<0.05）.3)CA125 combined with NLR and D-D increased the sensitivity and specificity for the diagnosis of ovarian endometriosis compared with one of its indicators alone.CA125 combined with NLR and FIB can significantly improve the specificity of ovarian endometriosis.Conclusions:1)The serum coagulation indexes and inflammatory factors in patients with ovarian endometriosis were abnormal,and there was a certain correlation between the serum coagulation indexes and inflammatory factors in patients with ovarian endometriosis.Abnormal coagulation function and inflammatory factors may promote the development of ovarian endometriosis.2)AFS score was positively correlated with D-D value and FIB value in patients with ovarian endometriosis.The higher the level of serum D-D and FIB,the higher the AFS score and the higher the stage of endometriosis.3)Combined detection of inflammatory factors,coagulation function and CA125 can improve the diagnosis rate of ovarian endometriosis.The combination of various serological indexes has certain advantages in the diagnosis of endometriosis,as well as the advantages of simplicity,strong operability and non-invasiveness,which is worth promoting in clinical practice.