血清维生素D、糖类抗原125及高迁移率簇蛋白B1水平与子宫内膜异位症患者临床分期的相关性分析

Analysis of correlation between levels of serum vitamin D,CA125 and HMGB1 and clinical staging of patients with endometriosis

目的探讨血清维生素D(VitD)、糖类抗原125(CA125)及高迁移率簇蛋白B1(HMGB1)水平变化与子宫内膜异位症(EMS)的关系。方法选取2018年12月至2019年12月我院收治的70例EMS患者作为研究对象(观察组),并纳入同期40例健康体检者为对照组。比较两组基线资料及VitD、CA125、HMGB1水平差异,评估不同病理类型、不同R-AFS分期EMS患者血清VitD、CA125、HMGB1表达差异,ROC曲线分析三个检测指标评估EMS患者临床分期的价值。结果观察组VitD低于对照组,CA125、HMGB1高于对照组(P<0.05);腹膜型、混合型VitD、CA125、HMGB1水平比较差异无统计学意义(P>0.05);卵巢型CA125、HMGB1水平高于腹膜型、混合型(P<0.05),VitD水平低于腹膜型、混合型(P<0.05);观察组不同分期VitD水平比较Ⅳ期<Ⅲ期<Ⅰ~Ⅱ期(P<0.05),CA125、HMGB1水平比较Ⅳ期>Ⅲ期>Ⅰ~Ⅱ期(P<0.05);相关分析VitD与R-AFS分期呈负相关(P<0.05),CA125、HMGB1均与R-AFS分期呈正相关(P<0.05);ROC曲线VitD、CA125、HMGB1均是评估EMD临床分期的有效指标(P<0.05),三项指标并联评估具有更高评估效能。结论血清VitD、CA125、HMGB1与EMS发生发展关系密切,监测其水平变化对临床诊治有积极意义。

Objective To explore the relationship between changes in levels of serum vitamin D(VitD),carbohydrate antigen 125(CA125)and high mobility group box B1(HMGB1)and endometriosis(EMS).Methods Seventypatients with EMS(observation group)who were admitted to our hospital between December 2018 and December 2019 were selected as experimentgroup,and another 40 healthy people from/in physical examination during the same time period were included in control group.The baseline data and levels of VitD,CA125 and HMGB1 were compared between the two groups.The expressions of serum VitD,CA125 and HMGB1 were evaluated among EMS patients with different pathological types and different R-AFS stages.ROC curve was used to analyze the value of the three detection indicators in evaluating clinical staging in patients with EMS.Results The VitD level was lower while the levels of CA125 and HMGB1 were higher in the observation group than those in the control group(P<0.05).There were no statistically significant differences in the levels of VitD,CA125 and HMGB1 between peritoneal type and mixed type(P<0.05).The levels of CA125 and HMGB1 of ovarian type were higher than those of peritoneal type and mixed type(P<0.05)while the VitD level of ovarian type was lower than that of peritoneal type and mixed type(P<0.05).The VitD level in observation group of different stages was shown as stage IV<stage III<stage I~II(P<0.05),and the levels of CA125 and HMGB1 showed as stage IV>stage III>stage I~II(P<0.05).Correlation analysis showed that VitD was negatively correlated with R-AFS staging(P<0.05)while CA125 and HMGB1 were positively correlated with R-AFS staging(P<0.05).ROC curve showed that VitD,CA125 and HMGB1 all were effective indicators to evaluate the clinical staging of EMD(P<0.05).The combination of the three indicators had higher evaluation efficacy.Conclusion Serum VitD,CA125 and HMGB1 are closely related to the occurrence and development of EMS.Monitoring the three indicators is significant/has positive implications for clinical diagnosis and treatment.