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目的探讨血清中糖类抗原125(CA125)、血管内皮生长因子(VEGF)和胰岛素样生长因子-1(IGF-1)的表达在子宫内膜异位症发生发展中的作用。方法选择子宫内膜异位症患者70例作为观察组,输卵管性不孕、卵巢畸胎瘤患者(非子宫内膜异位症)70例作为对照组,采用ELISA法检测血清中CA125、VEGF和IGF-1水平。结果观察组患者血清CA125、VEGF和IGF-1水平均高于对照组患者,差异有统计学意义(P<0.05)。子宫内膜异位症Ⅰ~Ⅱ期组患者血清CA125、VEGF和IGF-1水平均低于子宫内膜异位症Ⅲ~Ⅳ期组患者,差异有统计学意义(P<0.05)。观察组患者血清VEGF和IGF-1呈正相关(r=0.521,P=0.000),血清VEGF和IGF-1与血清CA125无相关性(P>0.05)。CA125诊断子宫内膜异位症的灵敏度为58.76%,特异度为80.54%;VEGF诊断子宫内膜异位症的灵敏度为81.02%,特异度为89.78%;IGF-1诊断子宫内膜异位症的灵敏度为75.78%,特异度为83.24%;CA125+VEGF+IGF-1联合诊断子宫内膜异位症的灵敏度为76.78%,特异度为96.21%。结论子宫内膜异位症患者血清CA125、VEGF和IGF-1升高,CA125、VEGF、IGF-1水平和子宫内膜异位症的严重程度有关,三者联合检测有助于子宫内膜异位症的诊断。
Objective To investigate the role of serum carbohydrate antigen 125 (CA125), vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1) in the development of endometriosis. Methods Seventy patients with endometriosis were selected as the observation group. 70 patients with tubal infertility and ovarian teratoma (non-endometriosis) were selected as the control group. Serum levels of CA125, VEGF and IGF-1 levels. Results The levels of serum CA125, VEGF and IGF-1 in the observation group were significantly higher than those in the control group (P <0.05). The levels of serum CA125, VEGF and IGF-1 in patients with endometriosis stage Ⅰ ~ Ⅱ were lower than those in patients with stage Ⅲ ~ Ⅳ endometriosis (P <0.05). There was a positive correlation between serum VEGF and IGF-1 in the observation group (r = 0.521, P = 0.000), serum VEGF and IGF-1 had no correlation with serum CA125 (P> 0.05). The sensitivity and specificity of CA125 in diagnosing endometriosis were 58.76% and 80.54% respectively. The sensitivity and specificity of VEGF in diagnosing endometriosis were 81.02% and 89.78%, respectively. The diagnosis of endometriosis by IGF-1 The sensitivity and specificity were 75.78% and 83.24% respectively. The sensitivity and specificity of CA125 + VEGF + IGF-1 in combined diagnosis of endometriosis were 76.78% and 96.21% respectively. Conclusions The serum levels of CA125, VEGF and IGF-1 in patients with endometriosis are elevated, and the levels of CA125, VEGF, IGF-1 and the severity of endometriosis are related. The combined detection of the three is helpful for the treatment of endometriosis Disorders diagnosis.