卵巢子宫内膜异位囊肿患者血清VEGF、BDNF水平变化及预测妊娠结局价值

Changes of serum vascular endothelial growth factor and brain derived neurocytotrophic factor levels of women with ovari-an endometriosis cyst and their predictive values for the pregnancy outcomes

目的:探讨卵巢子宫内膜异位囊肿患者血清血管内皮生长因子(VEGF)和脑源性神经细胞营养因子(BDNF)水平异常表达对妊娠结局的预测价值。方法:收集2018年3月-2020年1月本院收治的卵巢囊肿患者152例作为囊肿组,健康体检女性100例作为对照组,采集囊肿组入院时、对照组体检时血清检测VEGF和BDNF水平,统计两组及不同囊肿疾病分期患者的妊娠结局,采用受试者工作特征曲线(ROC)分析上述指标预测囊肿患者妊娠结局价值。结果:外周血VEGF、BDNF水平,囊肿组(406.35±123.27 pg/ml、1079.22±209.32 ng/L)均高于对照组(305.27±100.34 pg/ml、659.34±100.24 ng/L),且随着疾病分期增加两项指标水平升高,未受孕者均高于受孕者、劣质胚胎者高于优质胚胎、未流产者低于自然流产者、良好妊娠者低于不良妊娠(均P<0.05);ROC曲线分析显示,VEGF和BDNF预测卵巢子宫内膜异位囊肿患者妊娠结局的AUC分别为0.748(95%CI 0.606~0.890)、0.720(95%CI 0.581~0.859),预测妊娠结局的临界值分别为406.845 pg/ml、992.071 ng/L,此时的预测敏感度分别为68.4%、42.8%,特异度分别为68.0%、88.0%,两项联合的AUC为0.919(95%CI 0.872~0.966),敏感度93.8%,特异度30.5%。结论:卵巢子宫内膜异位囊肿患者外周血VEGF、BDNF水平异常升高,且随着疾病分期的增加而升高,早期检测可辅助临床预测患者妊娠,且联合检测的诊断价值更高。

Objective:To investigate the predictive values of the abnormal expression levels of the serum vascular endo-thelial growth factor(VEGF)and brain-derived neurocytotrophic factor(BDNF)of women with ovarian endometriosis cyst(OEC)for their pregnancy outcomes.Methods:152 women with OEC were collected in study group,and 100 women who came to hospital for physical examination were selected in control VEGF and BDNF group from March 2018 to January 2020.The serum of the women in the study group at the time of admission and the women in the control group during physical examination were obtained for detecting the levels of VEGF and BDNF.The pregnancy out-comes of the women in the two groups and the women with different stages of OEC were counted.Receiver operating characteristic curve(ROC)was used to analyze the predictive values of the levels of serum VEGF and BDNF for the pregnancy outcomes of the women with OEC.Results:The levels of serum VEGF and BDNF(406.35±123.27 pg/ml and 1079.22±209.32 ng/L)of the women in the study group were significantly higher than those(305.27±100.34 pg/ml and 659.34±100.24 ng/L)of the women in the control group,which of the women in the study group had increased significantly with the increase of OEC stage,and the levels of which of the women without pregnancy were significantly higher than those of the women with pregnancy,the levels of which of the women with inferior embryos were signif-icantly higher than those of the women with high-quality embryos,the levels of which of the women without abortion were significantly higher than those of the women with spontaneous abortion,and the levels of which of the women DOI:10.3969/issn.1004-8189.2023.03.026 with normal pregnancy were significantly higher than those of the women with poor pregnancy(all P<0.05).ROC curve analysis showed that the AUC of the VEGF level or the BDNF level of the women with OEC for predicting their pregnancy outcomes was 0.748(95%CI 0.606-0.890)or 0.720(95%CI 0.581-0.859),the critical values of which was 406.845 pg/ml or 992.071 ng/L,the sensitivity of which was 68.4%or 42.8%,and the specificity of which was 68.0%or 88.0%.The AUC,the sensitivity,and the specificity of the combined VEGF and BDNF levels of the women with OEC for predicting their pregnancy outcomes were 0.919(95%CI 0.872-0.966),93.8%,and 30.5%,respectively.Conclusion:The levels of the serum VEGF and BDNF of the women with OEC increase abnormally,and which increase with the elevation of the OEC stage of the women.Early detections of the serum VEGF and BDNF of the women with OEC can assist predicting their pregnancy outcomes in clinical,and the value of the combined detections of the serum VEGF and BDNF of the women for predicting their pregnancy outcomes is higher.