总胆固醇/甘油三酯预测子宫内膜异位症患者术后复发的价值

Value of Total Cholesterol/Triglyceride in Predicting Postoperative Recurrence of Endometriosis

目的重点探讨总胆固醇/甘油三酯(TC/TG)对子宫内膜异位症患者术后复发的预测价值。方法回顾分析,采集2020年1月至2022年6月于郑州大学第一附属医院妇科完成腹腔镜手术治疗后,且术后1 a随访期间复发的50例患者资料,纳入复发组;采集同期完成腹腔镜手术治疗后但术后随访1 a未复发的50例患者资料,纳入未复发组。全部患者资料完整(包括人口学资料、病历资料、相关实验室检查结果资料等)。记录患者人口学资料与临床资料,记录并比较两组术前血脂指标[TC、TG、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、TC/TG]检测结果。绘制受试者工作特征(ROC)曲线,重点分析各主要指标预测子宫内膜异位症患者术后复发风险的效能。结果复发组与未复发组患者人口学特征及临床资料差异无统计学意义(P>0.05);复发组术前TC、TG水平低于未复发组,TC/TG比值高于未复发组,差异有统计学意义(P<0.05);绘制ROC曲线,子宫内膜异位症患者的术前TC、TG、TC/TG比值预测术后复发风险均有一定效能,AUC均>0.70,其中TC/TG预测的AUC为0.905,预测价值最高,当cut-off取4.780,敏感度、特异度更高。结论子宫内膜异位症患者术前TC、TG、TC/TG比值均可用于预测术后复发风险,但TC/TG比值对复发风险的预测价值最高,具有更好的应用价值。

Objective To explore the predictive value of total cholesterol/triglyceride(TC/TG)in postoperative recurrence of endometriosis.Methods Retrospective analysis was conducted to collect the data of 50 patients who had relapsed after laparoscopy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from January 2020 to June 2022,and were included in the recurrence group during the one-year follow-up period after the surgery.The data of 50 patients who completed laparoscopic surgery in the same period but did not relapse after 1 year of follow-up were collected and included in the non recurrence group.All patient data were complete(including demography data,medical records,relevant laboratory examination results,etc.).The demography data and clinical data of patients were recorded,and the detection results of blood lipid indexes[TC,TG,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),TC/TG]before operation were recorded and compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of each main index in predicting the risk of postoperative recurrence in patients with endometriosis.Results There was no statistical significant difference in the demography characteristics and clinical data between the recurrence group and the non recurrence group(P>0.05).The preoperative TC and TG levels in the recurrence group were lower than those in the non recurrence group,and the TC/TG ratio was higher than that in the non recurrence group,with a statistical significant difference(P<0.05).The ROC curve was drawn,the preoperative TC,TG and TC/TG ratios of patients with endometriosis were all effective in predicting the postoperative recurrence risk.AUC was>0.70,among which the AUC predicted by TC/TG was 0.905,with the highest predictive value.When the cut off value was 4.780,the ideal sensitivity and specificity were higher.Conclusion The preoperative TC,TG,and TC/TG ratio in patients with endometriosis can be used to predict the risk of recurrence after surgery,but the TC/TG ratio has the highest predictive value for the risk of recurrence,and has a better application value.