| 许立云,刘翠霞,徐连芸,等.经阴道彩色多普勒超声结合血清 sFlt-1、TIMP-1在鉴别子宫肌瘤与子宫腺肌症中的应用价值[J].安徽医药,2025,29(2):358-362. |
| 经阴道彩色多普勒超声结合血清 sFlt-1、TIMP-1在鉴别子宫肌瘤与子宫腺肌症中的应用价值 |
| Application value of transvaginal color doppler ultrasound combined with serum sFlt-1 and TIMP-1 in the differentiation of uterine fibroid and adenomyosis |
| |
| DOI：10.3969/j.issn.1009-6469.2025.02.030 |
| 中文关键词: 平滑肌瘤 子宫腺肌病 经阴道彩色多普勒超声 可溶性 fms样酪氨酸激酶 -1 金属蛋白酶组织抑制因子 1 |
| 英文关键词: Leiomyoma Adenomyosis Transvaginal color doppler ultrasound Soluble fms-like tyrosine kinase 1 Tissue inhib-itor of metalloproteinase-1 |
| 基金项目: |
|
| 摘要点击次数: 656 |
| 全文下载次数: 417 |
| 中文摘要: |
| 目的分析经阴道彩色多普勒超声结合血清可溶性 fms样酪氨酸激酶 -1(sFlt-1)、金属蛋白酶组织抑制因子 1(TIMP-1)在鉴别子宫肌瘤与子宫腺肌症中的应用价值。方法选取 2021年 1月至 2023年 1月北京市昌平区中医医院收治的经病理确诊的子宫肌瘤和子宫腺肌症病人 160例为研究对象，其中子宫肌瘤病人 93例，子宫腺肌症病人 67例。对所有病人进行经阴道彩色多普勒超声诊断，酶联免疫法检测血清 sFlt-1、TIMP-1水平。 ROC曲线分析血清 sFlt-1、TIMP-1水平对子宫肌瘤与子宫腺肌症的鉴别诊断价值；四表格法分析经阴道彩色多普勒超声结合血清 sFlt-1、TIMP-1对子宫肌瘤与子宫腺肌症的鉴别价值。结果子宫肌瘤病人血清 sFlt-1［(1.34±0.25)μg/L比( 1.65±0.27)μg/L］、 TIMP-1［(135.28±7.63)μg/L比( 144.72±7.85)μg/L］水平显著低于子宫腺肌症病人，差异有统计学意义( P<0.05)。 ROC曲线结果表明，血清 sFlt-1水平鉴别子宫肌瘤与子宫腺肌症的 AUC为 0.79，灵敏度为 61.19%，特异度为 87.10%；血清 TIMP-1水平鉴别子宫肌瘤与子宫腺肌症的 AUC为 0.86，灵敏度为 64.18%，特异度为 93.55%。经阴道彩色多普勒超声诊断结果显示， 93例子宫肌瘤病人中， 82例确诊， 11例误诊； 67例子宫腺肌症病人中， 45例确诊， 22例误诊，其诊断鉴别子宫肌瘤与子宫腺肌症的灵敏度为 67.16%(45/67)，特异度为 88.17%(82/93)确度为 79.38%(127/160)；经阴道彩色多普勒超声诊断鉴别结果与病理诊断结果具有较好一致性( Kappa=0.57， 道彩色多普勒超声结合血清 sFlt-1、TIMP-1鉴别子宫肌瘤与子宫腺肌症的灵敏度为 97.01%(65/67)特异度为 86.02%(80/93)，准确度为90.63%(145/160)；三者联合鉴别子宫肌瘤与子宫腺肌症的结果与病理诊断结果具有一致性( Kappa=0.81， P<0.05)。经阴准较好，P<0.05)。联合检测鉴别子宫肌瘤与子宫腺肌症的灵敏度和准确度显著高于经阴道彩色多普勒超声、 sFlt-1、TIMP-1单独诊断( P< 0.05)。结论经阴道彩色多普勒超声结合血清 sFlt-1、TIMP-1在鉴别子宫肌瘤与子宫腺肌症中具有重要应用价值。 |
| 英文摘要: |
| Objective To analyze the application value of transvaginal color doppler ultrasound combined with serum soluble fms-like tyrosine kinase 1 (sFlt-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the differentiation of uterine fibroid and adenomy-osis.Methods From January 2021 to January 2023, 160 patients with uterine fibroid and adenomyosis diagnosed by pathology in ourhospital were collected as the study subjects, including 93 patients with uterine fibroid and 67 patients with adenomyosis. Transvaginalcolor Doppler ultrasound diagnosis were performed on all patients, enzyme-linked immunosorbent assay was applied to detect serum levels of sFlt-1 and TIMP-1. Receiver operating characteristic was applied to analyze the value of serum sFlt-1 and TIMP-1 levels in the differential diagnosis of uterine fibroid and adenomyosis; four grid table method was applied to analyze the differential value oftransvaginal color doppler ultrasound combined with serum sFlt-1 and TIMP-1 for uterine fibroid and adenomyosis.Results The se-rum levels of sFlt-1 [(1.34±0.25)μg/L vs. (1.65±0.27)μg/L] and TIMP-1[(135.28±7.63)μg/L vs. (144.72±7.85)μg/L] in patients with uterine fibroid were obviously lower than those in patients with adenomyosis (P<0.05). The results of receiver operating characteristic showed that the AUC of serum sFlt-1 level in differentiating uterine fibroid from adenomyosis was 0.79, the sensitivity was 61.19%, andthe specificity was 87.10%; the AUC of serum TIMP-1 level in differentiating uterine fibroid from adenomyosis was 0.86 the sensitivitywas 64.18%, and the specificity was 93.55%. The results of transvaginal color doppler ultrasound showed that 82 of 93 patients withuterine fibroid were diagnosed and 11 were misdiagnosed; among 67 cases of adenomyosis, 45 cases were diagnosed and 22 cases weremisdiagnosed, the sensitivity, specificity and accuracy in the diagnosis of uterine fibroid and adenomyosis were 67.16% (45/67), 88.17% (82/93) and 79.38% (127/160) respectively; the differential diagnosis results of transvaginal color doppler ultrasound had goodconsistency with the pathological diagnosis results (Kappa=0.57, P<0.05). The sensitivity, specificity and accuracy of transvaginal color Doppler ultrasound combined with serum sFlt-1 and TIMP-1 in distinguishing uterine fibroid from adenomyosis were 97.01% (65/67),86.02% (80/93) and 90.63% (145/160) respectively; the results of combined differentiation of the three methods in distinguishing uter-ine fibroid from adenomyosis were consistent with the pathological diagnosis (Kappa=0.81, P<0.05). The sensitivity and accuracy ofcombined detection in distinguishing uterine fibroid and adenomyosis were obviously higher than those of transvaginal color doppler ul-trasound, sFlt-1 and TIMP-1 alone (P<0.05). Conclusion Transvaginal color doppler ultrasound combined with serum sFlt-1 and TIMP-1 has important application value in the differentiation of uterine fibroid and adenomyosis. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
