阴道超声联合MMP-9、膜联蛋白A2检测在子宫腺肌病中的诊断价值

Diagnosis Value of Vaginal Ultrasound Combined Detection of MMP-9 and ANXA2 in Adenomyosis

目的探讨阴道超声联合基质金属蛋白酶-9(Matrix metallopeptidase-9,MMP-9)、膜联蛋白A2(Annexin A2,ANXA2)检测在子宫腺肌病(Adenomyosis,AM)患者中的诊断价值.方法选取行子宫切除术的患者60例,根据术后病理结果分为AM患者26例,子宫肌瘤患者34例.所有患者于术前行经阴道超声检查,并术前检测MMP-9,ANXA2的表达水平.利用ROC曲线分析经阴道超声检查、血清MMP-9,ANXA2单独及联合检测的诊断价值.结果研究组血清中MMP-9和ANXA2的水平明显高于对照组(P<0.05);研究组子宫动脉血流阻力指数显著高于对照组,差异具有统计学意义(P<0.05);三者系列联合检测AM的特异度为85.29%,显著高于三者单独检测和平行联合检测的特异度(82.35%,5.88%,73.53%,47.06%)(P<0.05),同时约登指数(0.622)和准确度(81.67%)最高; ROC曲线显示:经阴道超声、MMP-9和ANXA2系列联合检测的ROC曲线下面积显著高于经阴道超声、MMP-9和ANXA2单独检测,差异具有显著的统计学意义(P<0.05).结论阴道超声联合检测MMP-9、膜联蛋白ANXA2可以提高AM诊断的准确度.

Objective To explore the diagnosis value of vaginal ultrasound combined with Matrix metalloproteinases 9(MMP-9)and Annexin A2(ANXA2)in Adenomyosis(AM).Method 60 cases of hysterectomy patients were selected.According to postoperative pathological feedback,26 patients were AM and 34 patients were fibroids.All patients received vaginal ultrasound examination before operation and preoperative serum detection of MMP-9,ANXA2 expression level were detected.Diagnostic value of vaginal ultrasound,serum MMP-9,ANXA2 and its joint test were analyzed via ROC curve.Results MMP-9 and ANXA2 levels in serum of the study group were significantly higher than those of the control group(P<0.05).The index of uterine arterial blood flow resistance in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The specificity of the 3-series combined detection AM was 85.2 9%,significantly higher than the specificity of the 3-series combined detection and parallel combined detection(82.3 5%,5.88%,73.53%,47.06%)(P<0.05),with the highest Yoden index(0.622)and accuracy(81.6 7%).The ROC curve showed that the area under the ROC curve detected jointly by transvaginal ultrasonography,MMP-9 and ANXA2 was significantly higher than that separately detected by transvaginal ultrasonography,MMP-9 and ANXA2,showing a significant statistical difference(P<0.05).Conclusion Vaginal ultrasonography combined with MMP-9 and MP-ANXA2 can improve the diagnosis accuracy of AM.