Application value of inflammation value combined with chemokines in predicting recurrence risk of uterine fibroids after operation
Liu Zhihui
Wang Lingling
Gu Zhenpeng
Cui Jinxiu
Abstract：Objective To investigate the influencing factors and predictive value of the pan-immune inflammation value and chemokine expression profile in the recurrence after laparoscopic myomectomy.Methods Clinical data of 104 pa-tients who underwent laparoscopic myomectomy at the Department of Obstetrics and Gynecology of Beijing Chaoyang Hos-pital,Capital Medical University and the Affiliated Hospital of Binzhou Medical University from January 2020 to February 2022 were retrospectively analyzed.According to the postoperative recurrence,the patients were divided into non-recur-rence group(n=81)and recurrence group(n=23).The general clinical data,blood cell-related inflammatory indicators[erythrocyte sedimentation rate(ESR),pan-immune inflammation value(PIV),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR)],chemokine levels[CC chemokine ligand(CCL)2,CCL8,CCL21],and sex hormone levels[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T)]were compared between the two groups.Logistic regression analysis was used to screen out the risk factors for recur-rence after laparoscopic myomectomy.Receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate the predictive value of each risk factor independently and jointly for recurrence after laparoscopic myomec-tomy.Results The proportion of patients with a family history of uterine fibroids,ESR,PIV,NLR,CCL8,CCL21,FSH,LH,and E2 levels were higher in the recurrence group than in the non-recurrence group(x2/t/P=6.124/0.013,3.602/＜0.001,4.278/＜0.001,3.905/＜0.001,4.454/＜0.001,3.841/＜0.001,4.123/＜0.001,3.351/0.001,4.285/＜0.001).Spearman correlation anal-ysis and Logistic regression analysis showed that higher PIV,NLR,CCL8,CCL21,and E2 levels were significant risk factors for recurrence after laparoscopic myomectomy[OR(95％CI)=1.026(1.006-1.046),4.978(1.018-7.776),1.231(1.058-1.432),1.066(1.016-1.118),1.032(1.004-1.060)].ROC analysis showed that the AUCs of PIV,NLR,CCL8,CCL21 alone and the combination of the factors for predicting postoperative recurrence of uterine fibroids were 0.762,0.703,0.799,0.739,and 0.966,respectively.The combined prediction of the five factors was better than that of each factor alone(Z=3.876,4.145,3.722,3.956,all P＜0.05).Conclusion Postoperative inflammatory indicators and chemokine levels can be combined with sex hor-mones to predict the risk of recurrence in patients after laparoscopic myomectomy.For such patients,close monitoring of in-flammatory response levels and sex hormone changes after surgery is of certain clinical significance for preventing disease recurrence.
Keywords：Uterine fibroidsHysteromyomectomyRecurrencePan-immune inflammation valueChemokine
Publication Date：2025-03-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 333-337 )