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目的研究糖链抗原(carbohydrate antigen,CA)125、CA19-9、中性粒细胞/淋巴细胞比值(neutrophil-tolymphocytes ratio,NLR)及其联合应用对子宫内膜异位症(endometriosis,EM)的诊断价值。方法拟诊EM并行腹腔镜检查患者251例,根据CA125、CA19-9和NLR等指标,采用ROC和logistic回归方程分析3项指标及其联合检测对EM的诊断价值;分析3项指标相关性及其与患者临床特征间的关系。结果以腹腔镜检查结果为标准,158例EM患者为EM组,93例非EM患者为非EM组,EM组CA125[(64.00±39.00)u/mL]、CA19-9[(27.00±14.00)u/mL]、NLR(2.91±1.28)高于非EM组[(37.00±26.00)u/mL、(20.00±13.00)u/mL、2.18±1.14](P<0.05);CA125与NLR、CA19-9无明显相关性(r=0.110,P=0.170;r=0.120,P=0.160),CA19-9与NLR呈正相关(r=0.170,P=0.040);CA125、CA19-9和NLR诊断EM的AUC分别为0.73、0.68和0.70,3项联合诊断的AUC(0.78)高于单项指标的AUC;CA125、CA19-9和NLR均随EM分期的递进而增加(P<0.01)。结论 CA125、CA19-9和NLR联合诊断可提高EM诊断的准确性。
Objective To investigate the effects of carbohydrate antigen (CA) 125, CA19-9, neutrophil-tolymphocytes ratio (NLR) and their combination on endometriosis (EM) Diagnostic value. Methods Totally 251 patients with EM complicated with laparoscopy were enrolled. According to the indexes of CA125, CA19-9 and NLR, ROC and logistic regression equations were used to analyze the diagnostic value of three indexes and their combined detection to EM. The correlation between the three indexes and Its relationship with the clinical features of patients. Results According to the results of laparoscopy, 158 patients with EM were in the EM group and 93 patients with non-EM were non-EM group. CA125 [(64.00 ± 39.00) u / mL], CA19-9 [(27.00 ± 14.00) (37.00 ± 26.00) u / mL, (20.00 ± 13.00) u / mL, 2.18 ± 1.14] (P <0.05); CA125 and NLR, CA19 (R = 0.110, P = 0.170; r = 0.120, P = 0.160). There was a positive correlation between CA19-9 and NLR (r = 0.170, P = 0.040) The AUC was 0.73, 0.68 and 0.70 respectively. The AUC (0.78) was higher than the single index (AUC) of 3 items. The CA125, CA19-9 and NLR increased with the progress of EM staging (P <0.01). Conclusion Combined diagnosis of CA125, CA19-9 and NLR can improve the accuracy of EM diagnosis.