血清IGF-1、IGFBP-3与多发性子宫肌瘤的相关性分析

Analysis of the correlation between serum IGF-1, IGFBP-3 and multiple uterine fibroids

目的探讨血清胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)与多发性子宫肌瘤的相关性。方法选择2017年1月至2020年12月在青岛大学青岛医学院接诊的300例多发性子宫肌瘤患者(多发肌瘤组),同期单独子宫肌瘤患者55例(单发肌瘤组),另选择同期在本院进行检查的120例健康人群为对照组,分析三组患者血清IGF-1、IGFBP-3水平变化情况及相关性,并分析血清IGF-1、IGFBP-3在多发性子宫肌瘤中的诊断价值。结果多发肌瘤组患者血清IGF-1水平显著高于单发肌瘤组、对照组,IGFBP-3水平显著低于单发肌瘤组、对照组;多发性子宫肌瘤血清IGF-1、IGFBP-3水平与年龄、最大肌瘤直径及肿瘤体积无显著相关性,与肿瘤数量密切相关(P <0.05);IGF-1、IGFBP-3联合检测诊断多发性子宫肌瘤的AUC为0.998,95%CI为0.995~1.000,联合检测的特异度、准确度分别为93.28%、94.13%。结论在多发性子宫肌瘤患者中血清IGF-1、IGFBP-3的表达与肿瘤数量密切相关,可作为多发性子宫肌瘤的特异性指标。

Objective To study the correlation between serum Insulin-like growth factor-1(IGF-1), insulin-like growth factor-binding protein 3(IGFBP-3) and multiple uterine fibroids. Methods 300 patients with multiple uterine fibroids were selected as study group A, 55 patients with single uterine fibroids as study group B, 20 healthy people as control group, which all treated in our hospital between January 2017 and December 2020. The serum IGF-1, IGFBP-3 level of three groups were tested and the diagnostic value for uterine fibroids were analyzed. Results The IGF-1 level of patients in the study group A were significantly higher than study group B and the control group, and the IGFBP-3 level were significantly lower(P < 0.05). According to variance and T-test analysis, the serum IGF-1 and IGFBP-3 levels of multiple uterine fibroids were not significantly correlated with age, maximum fibroid diameter and tumor volume, but were closely correlated with tumor number(P < 0.05). The AUC of IGF-1 in the diagnosis of multiple uterine fibroids was 0.921, 95%CI was 0.897 ~ 0.982, the AUC of IGFBP-3 in the diagnosis of multiple uterine fibroids was 0.843, 95%CI was 0.802 ~ 0.855, and the AUC of combined detection was 0.998, 95%CI was 0.995 ~ 1.000. There were significant differences in the area under the curves of separate detection and combined detection(Z = 4.271, 7.373, P < 0.05). The specificity and accuracy of combined detection were 93.28% and 94.13%, respectively. Conclusion The expression of serum IGF-1 and IGFBP-3 in patients with multiple uterine fibroids are closely related to the number of tumors, and they can be used as important indicators for the diagnosis of multiple uterine fibroids.