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血清转化生长因子-β1、胰岛素样生长因子-1与子宫腺肌症患者病理特征及术后复发的关系

Correlations of serum transforming growth factor-β1 and insulin-like growth factor-1 with pathological features and postoperative recurrence in patients with adenomyosis

    摘要
  • 摘要:
    目的 探讨血清转化生长因子-β1(TGF-β1)、胰岛素样生长因子-1(IGF-1)表达水平与子宫腺肌症患者临床病理特征的关系及其预测患者术后复发的临床价值。
    方法 选取82例子宫腺肌症患者作为研究对象(研究组)。术后对患者进行为期2年的随访, 依据术后复发情况将患者分为复发组(n=15)和未复发组(n=67)。另选取同期进行体检的85例健康者为对照组。比较研究组与对照组血清TGF-β1、IGF-1表达水平。分析血清TGF-β1、IGF-1表达与子宫腺肌症患者临床病理特征的关系。比较复发组与未复发组血清TGF-β1、IGF-1表达水平。采用受试者工作特征(ROC)曲线分析血清TGF-β1、IGF-1水平对子宫腺肌症患者术后复发的预测效能。
    结果 研究组血清TGF-β1、IGF-1表达水平高于对照组，差异有统计学意义(P < 0.05)。血清TGF-β1表达水平与患者月经量、人流刮宫史、子宫体积、病理类型、病灶体积、子宫内膜状态、异位腺体周期相关(P < 0.05)。血清IGF-1表达水平与患者月经量、人流刮宫史、子宫体积、病理类型、子宫内膜状态、异位腺体周期相关(P < 0.05)。术后复发组血清TGF-β1、IGF-1表达水平均高于未复发组，差异有统计学意义(P < 0.05)。ROC曲线显示，血清TGF-β1、IGF-1水平以及二者联合预测子宫腺肌症患者术后复发的曲线下面积(AUC)分别为0.823、0.803和0.940。血清TGF-β1、IGF-1水平联合预测患者术后复发的效能优于其单独预测(Z二者联合-TGF-β1=2.001、Z二者联合-IGF-1=2.318, P=0.045、0.021)。
    结论 子宫腺肌症患者的血清TGF-β1、IGF-1显著升高，其与患者临床病理特征密切相关。血清TGF-β1、IGF-1水平联合预测患者术后复发的临床价值较高。

     

    Abstract:
    Objective To investigate the correlations of expression levels of serum transforming growth factor-β1 (TGF-β1) and insulin-like growth factor-1 (IGF-1) with clinicopathological features of patients with adenomyosis, and the clinical value of their prediction of postoperative recurrence.
    Methods Eighty-two patients with adenomyosis were selected as study subjects (study group). Patients were followed up for two years after surgery and divided into recurrence group (n=15) and non-recurrence group (n=67) based on their postoperative status. An additional 85 healthy individuals who underwent physical examinations during the same period were selected as control group. Serum TGF-β1 and IGF-1 levels were compared between the study group and the control group. The correlations of serum TGF-β1 and IGF-1 levels with the clinicopathological characteristics of adenomyosis patients was analyzed. Serum TGF-β1 and IGF-1 levels were compared between the recurrence and non-recurrence groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of serum TGF-β1 and IGF-1 levels in predicting postoperative recurrence in adenomyosis patients.
    Results Serum TGF-β1 and IGF-1 levels in the study group were significantly higher than those in the control group (P < 0.05). Serum TGF-β1 levels were correlated with menstrual volume, history of curettage, uterine volume, pathological type, lesion volume, endometrial status and ectopic gland cycle (P < 0.05). Serum IGF-1 levels were correlated with menstrual volume, history of curettage, uterine volume, pathological type, endometrial status and ectopic gland cycle (P < 0.05). Postoperative serum TGF-β1 and IGF-1 levels in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for predicting postoperative recurrence using serum TGF-β1, IGF-1 and their combination were 0.823, 0.803 and 0.940, respectively. The clinical efficacy of TGF-β1 and IGF-1 in combination in predicting postoperative recurrence was superior to that of TGF-β1 alone (Zcombined with TGF-β1=2.001, Zcombined with IGF-1=2.318, P=0.045, 0.021).
    Conclusion The serum levels of TGF-β1 and IGF-1 in patients with adenomyosis are significantly increased, which are closely related to the clinicopathological features of the patients. The combination of serum TGF-β1 and IGF-1 levels has high clinical efficacy in predicting postoperative recurrence.

     

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