EMs腹腔镜手术患者术前SII、MMP-9水平与术后复发关系

Correlation between the levels of the preoperative systemic immune inflammation and matrix metalloproteinase-9 of women with endometriosis and their postoperative recurrence of endometriosis

目的:探讨子宫内膜异位症(EMs)患者术前系统性免疫炎症指数(SII)、基质金属蛋白酶-9(MMP-9)水平与腹腔镜手术治疗后复发的关系。方法:收集2019年1月-2020年1月本院妇科收治的接受EMs腹腔镜手术治疗患者80例临床资料为EMs组,体检健康育龄妇女80例为对照组,比较两组血清SII、MMP-9、糖类抗原(CA)12-5水平,分析其预测EMs术后复发的临床价值。结果:随访24个月期间EMs复发率为13.8%。血清SII、MMP-9水平,术前EMs组[415.24(291.81~573.09)]M(P25,P75)、(229.65±66.34μg/L)均高于对照组[326.55(249.74~381.62)]M(P25,P75)、(160.78±42.15μg/L),复发组高于未复发组,r-AFSⅢ~Ⅳ期患者高于Ⅰ~Ⅱ期患者(均P<0.05)。Spearman相关系数分析,EMs患者术前血清SII、MMP-9水平与术后复发呈正相关(P<0.05),2项指标联合预测EMs术后复发的曲线下面积(0.874)高于SII(0.825)、MMP-9(0.767),特异度为91.3%。结论:术前血清SII、MMP-9水平较高的EMs患者术后复发风险增加,2项指标联合预测术后复发可能有临床指导价值。

Objective:To investigate the correlation between the levels of the preoperative systemic immune inflammation(SII)and matrix metalloproteinase-9(MMP-9)of women with endometriosis(EMs)and their postoperative recurrence of EMs.Methods:80 women with EMs who wanted laparoscopic surgery were selected in study group,and 80healthy women of childbearing age who wanted the physical examination were selected in control group from January 2019 to January 2020.The levels of the serum SII,MMP-9 and carbohydrate antigen(CA)12-5 of the patients were compared between the two groups,and the clinical values of which for predicting the postoperative recurrence of EMs of the patients were analyzed.Results:The recurrence rate of EMs of the patients in the study group was 13.8% during 24 months of the follow-up.The levels of the preoperative serum SII[415.24(291.81-573.09)and M(P25,P75)]and MMP-9(229.65±66.34μg/L)of the patients in the study group were significantly higher than those[326.55(249.74-381.62)and M(P25,P75),and(160.78±42.15μg/L)]of the patients in the control group,and which of the patients with the recurrence of EMs were all significantly higher than those of the patients without the recurrence of EMs,and which of the patients with the r-AFS Ⅲ-Ⅳ of EMs were also significantly higher than those of the patients with the r-AFS Ⅰ-Ⅱ of EMs(all P<0.05).Spearman correlation coefficient analysis showed that the preoperative serum SII and MMP-9 levels of the patients with EMs were positively correlated with their postoperative recurrence of EMs(P<0.05).The area under the curve(0.874)of the combination of the preoperative serum SII and MMP-9 levels of the patients with EMs for predicting their postoperative recurrence of EMs was significantly higher than that(0.825)of the SII level or that(0.767)of the MMP-9 level alone,and the specificity of which was 91.3%.Conclusion:The patients with EMs and the higher levels of the preoperative serum SII and MMP-9have the higher risk of the postoperative recurrence of EMs.The combination of the preoperative serum SII and MMP-9 levels of the patients with EMs for predicting their postoperative recurrence of EMs has some value for the clinical guidance.