| Objective: To investigate the combined diagnostic value of preoperative LDH,NLR,PLR,SII,D-dimer and RI for uterine sarcoma.Methods: The clinical data of 63 patients with uterine sarcoma who underwent surgical treatment in the Affiliated Hospital of Qingdao University from December 2018 to December 2021 were retrospectively analyzed.126 patients with hysteromyoma confirmed by surgery and pathology during the same period were selected as the hysteromyoma group in a ratio of 1:2.Preoperative general data of all patients,peripheral blood routine,D-dimer and LDH results within 1 week were statistically analyzed,and the values of NLR,PLR and SII were calculated to compare the differences of each index value between the two groups.LDH,D-dimer,NLR,PLR,SII and RI were detected and their combined detection value in the diagnosis of uterine sarcoma was compared.Results: 1.Comparison of general clinical data between the two groups: in the uterine sarcoma group,the mean age and mean number of deliveries were higher than in the uterine fibroid group,with significant differences(P < 0.05);There were more menopause cases in the uterine sarcoma group than in the fibroid group,and the difference was statistically significant(P < 0.001;The mean gestational age and the presence or absence of abnormal vaginal bleeding in the uterine sarcoma group were not significantly different from those in the uterine fibroid group(P > 0.05).2.Comparison of preoperative peripheral blood markers LDH,D-dimer,PLR,NLR,SII and ultrasound RI between the two groups: Patients with uterine sarcoma had higher preoperative LDH,D-dimer NLR,SII than patients with uterine fibroid,with statistically significant differences(P < 0.05).However,the PLR and RI levels in the uterine sarcoma group were smaller than those in the uterine fibroid group,with significant differences(P < 0.001).3.The preoperative ultrasound data of the two groups were compared: the proportion of tumors in the uterine sarcoma group with indistinct borders with surrounding tissues was higher than that in the uterine fibroid group,the incidence of a single tumor in the uterine sarcoma group was higher than that in the leiomyoma group,and the blood resistance index in the uterine sarcoma group was lower than that in the fibroid group,all of which were statistically significant(P < 0.001),but there was no statistically significant difference in the comparison of the maximum tumor diameter between the two groups(P > 0.05).4.Logistic regression analysis of ultrasound features the results of logistic regression analysis of ultrasound features that were significant in univariate analysis suggested that RI(or = 0.000)was a protective factor for us(P < 0.05);The correlation between us and whether the tumor was solitary or borderline(clear or unclear)was not significant(P > 0.05).5.Analysis of the diagnostic value of preoperative serum LDH,D-dimer,PLR,NLR,and SII in combination with RI of ultrasound in uterine sarcoma: ROC curves were plotted for the diagnosis of uterine sarcoma by serum LDH,D-dimer,PLR,NLR,SII,RI alone and in combination,AUCs were 0.664,0.746,0.851,0.597,0.597,0.893,The sensitivity and accuracy were higher than that of both single test and combined test of laboratory indexes,and the differences were statistically significant(P < 0.05).6.Comparison of the levels of each laboratory test indicators in different pathological types before operation: LDH,D-dimer,NLR,SII of serum laboratory test indicators in preoperative patients had no obvious difference in different pathological types of uterine sarcoma,the P values were 0.380,0.613,0.578,0.312,PLR values of patients with smooth muscle sarcoma were significantly lower than those of patients with other pathological types,the differences were statistically significant(P < 0.05).Conclusion 1.The relevant indicators of preoperative uterine sarcoma: LDH,D-dimer,NLR,SII were higher than those in the uterine fibroid group,while PLR and RI levels were lower than those in the uterine fibroid group.2.The PLR value of patients with leiomyosarcoma is significantly lower than that of patients with other pathological types of uterine sarcoma,and PLR has certain significance in distinguishing leiomyosarcoma from patients with other pathological types of sarcoma.3.The combined detection of LDH,D-dimer,PLR,NLR,SII,and ultrasound RI in patients’ serum before surgery can improve the predictive value of uterine sarcoma diagnosis and serve as a reference indicator for disease monitoring. |
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