Clinical Predictive Significance Of NLR,Coagulation-related Factors And CA125 In Endometriosis

Objective:By retrospectively analyzing the clinical data of patients with endometriosis,To investigate the clinical predictive value of NLR,coagulation-related factors,CA125 and their combined markers for endometriosis,The aim is to find a simple and cost-effective peripheral blood marker for the early diagnosis and assessment of endometriosis patients.Methods:The clinical data of 200 patients with pathologically confirmed endometriosis after minimally invasive surgery at the Third Affiliated Hospital of Southern Medical University from January 2015 to December 2020 and 110 patients with pathologically confirmed benign ovarian tumors during the same period were retrospectively analyzed.Preoperative peripheral blood inflammation and coagulation indexes were collected:WBC,PLT,NE,LY,NLR,PLR,PT,APTT,TT,FIB and serum CA125.Statistical analysis with SPSS 23.0 software was used to investigate the influence and correlation of NLR,coagulation-related factors and CA125 on the staging and diagnosis of endometriosis.The ROC curves were plotted and the AUC,sensitivity,specificity and optimal diagnostic threshold were calculated to further investigate the clinical predictive value of the above indicators for endometriosis.Results:1.BMI was lower in the endometriosis group than in the control group(P<0.05),and PLR,NLR,and FIB were higher in the endometriosis group than in the control group(P<0.05),with NLR and FIB having more significant significance(P<0.01),However,WBC,NE,LY,PLT,PT,ATPP,TT were not statistically different in the two groups(P>0.05);2.NE,NLR,FIB,and CA125 increased with the progressive stage of endometriosis(P<0.05),Among them,NE,FIB,and CA125 were more significant(P<0.01),However,WBC,LY,PLR,PLT,PT,ATPP,and TT were not statistically different in each stage of endometriosis(P>0.05),but PLT increased with the staging;3.NE,NLR,FIB,and CA125 were significantly higher in the severe endometriosis group than in the mild endometriosis group(P<0.01),WBC,NE,LY,PLT,ATPP,and TT were not statistically different in the two groups(P>0.05),However,WBC,NE,and PLT were higher in the severe group than in the mild group,and LY were lower than in the mild group;4.FIB and CA125 are risk factors for the development of endometriosis and are significantly and positively correlated with the development of endometriosis,and NLR,FIB and CA125 are risk factors for heavy endometriosis and are positively correlated with the severity of endometriosis;5.The diagnostic rate of NLR was higher than that of CA125 in patients with mild(stage Ⅰ-Ⅱ)endometriosis(50%vs 8%),and in patients with severe(stage Ⅲ and Ⅳ)endometriosis,the highest diagnostic rate was achieved with the combination of NLR,FIB,and CA125,with higher and similar rates of NLR and CA125(81%vs 77%vs 74%);6.The combination of NLR,FIB,and CA125 has a higher diagnostic accuracy than CA125 alone AUC=0.895,95%CI(0.853-0.938),sensitivity 81%,specificity 85%,and optimal diagnostic threshold 162.7.Conclusions:1.Relative blood hypercoagulation and inflammatory state in patients with endometriosis,NLR,FIB and CA125 as diagnostic indicators were positively correlated with the severity of endometriosis;2.NLR has a high diagnostic yield for mild endometriosis and CA125 for heavy endometriosis,but the sensitivity and specificity of both are unsatisfactory;3.The combined test of NLR,FIB,and CA125 has a higher clinical predictive value for endometriosis than the separate test,improves the sensitivity of diagnosis,and has similar specificity,but the overall diagnostic rate is still not high and cannot be used as an ideal criterion for the diagnosis of endometriosis.