卵巢良性肿瘤患者术后血清抗缪勒管激素水平及其卵巢储备功能的相关性

Correlation between postoperative serum anti-Mullerian hormone level and ovarian reserve function in patients with benign ovarian tumors

目的探讨卵巢良性肿瘤患者术后血清抗缪勒管激素(AMH)水平及其卵巢储备功能的相关性。方法回顾性分析我院2018年1月~2021年1月行手术治疗的107例卵巢良性肿瘤患者临床资料,根据术后3个月时患者窦卵泡计数(AFC)评估卵巢储备功能,将患者分为低功能组(n=41)、正常组(n=66)。比较两组患者术前、术后3个月时血清AMH、卵泡刺激素(FSH)、抑制素B(INHB)水平差异,使用受试者工作特征(ROC)曲线分析血清AMH、FSH、INHB对卵巢储备功能的评估效能,使用Pearson相关分析探究术前、术后3个月时AFC与血清AMH、FSH、INHB的相关性。结果术后3个月时,两组患者血清AMH、INHB均较术前下降,且低功能组患者血清AMH、INHB均低于正常组,两组患者血清FSH均较术前上升,低功能组患者血清FSH高于正常组(均P<0.05);ROC曲线结果显示,术后3个月时血清AMH、FSH、INHB对卵巢储备功能的评估效能均较高(AUC=0.825、0.693、0.714,均P<0.05);经Pearson相关性分析,术前单侧AFC与血清AMH、FSH、INHB水平无相关性(r=0.030、0.013、0.022,均P>0.05),术前双侧AFC与血清AMH、INHB正相关(r=0.418、0.405,均P<0.05),与血清FSH负相关(r=-0.312,P<0.05),术后3个月时AFC与血清AMH、INHB正相关(r=0.614、0.553,均P<0.05),AFC与血清FSH负相关(r=-0.356,P<0.05)。结论卵巢良性肿瘤手术可导致患者卵巢储备功能受到一定程度负面影响,血清AMH、FSH、INHB可用于评估患者术后3个月时卵巢储备功能,且术前双侧、术后3个月时AFC与血清AMH、FSH、INHB水平存在显著相关性。

Objective To study the correlation between postoperative serum anti-Mullerian hormone(AMH)level and ovarian reserve function in patients with benign ovarian tumors.Methods The clinical data of 107 patients with benign ovarian tumors who underwent surgical treatment in the hospital between January 2018 and January 2021 were retrospectively analyzed.According to ovarian reserve function assessed by antral follicle count(AFC)at 3 months after surgery,the patients were divided into low function group(n=41)and normal group(n=66).The differences in levels of serum AMH,follicle stimulating hormone(FSH)and inhibin B(INHB)were compared between the two groups of patients before surgery and at 3 months after surgery.Receiver operating characteristic(ROC)curve was used to analyze the evaluated efficiency of levels of serum AMH,FSH and INHB on ovarian reserve function.Pearson correlation analysis was applied to explore the correlation between AFC before surgery and at 3 months after surgery and serum AMH,FSH and INHB.Results At 3 months after surgery,the levels of serum AMH and INHB of the two groups were decreased compared with those before surgery,and the levels of serum AMH and INHB of low function group were lower than those of normal group,and the level of serum FSH of the two groups was increased compared with that before surgery,and the level of serum FSH was higher in low function group than that in normal group(all P<0.05).ROC curve results showed that serum AMH,FSH and INHB had high evaluated efficiency on ovarian reserve function at 3 months after surgery(AUC=0.825,0.693,0.714,all P<0.05).According to Pearson correlation analysis,unilateral AFC before surgery was not correlated with levels of serum AMH,FSH and INHB(r=0.030,0.013,0.022,all P>0.05),and bilateral AFC before surgery was positively correlated with serum AMH and INHB(r=0.418,0.405,all P<0.05)while AFC was negatively correlated with serum FSH(r=-0.312,P<0.05),and AFC at 3 months after surgery was positively correlated with levels of serum AMH and INHB(r=0.614,0.553,all P<0.05)and AFC was negatively correlated with serum FSH(r=-0.356,P<0.05).Conclusion Surgery for benign ovarian tumors can cause a certain degree of negative impact on ovarian reserve function of patients.Serum AMH,FSH and INHB can be used to assess the ovarian reserve function at 3 months after surgery,and bilateral AFC before surgery and AFC at 3 months after surgery are significantly correlated with levels of serum AMH,FSH and INHB.