Role and clinical significance of coagulation and inflammatory factors in moderate and severe ovarian endometriosis / 中华妇产科杂志

ABSTRACT

Objective To determine the levels of coagulation and inflammatory factors in women with moderate and severe ovarian endometriosis so as to investigate the possible role of coagulation and inflammatory factors in the pathogenesis, diagnosis and treatment of this disease. Methods From June 2015 and June 2017,clinical data of 366 patients with pathologically diagnosed moderate and severe ovarian endometriosis (case group) and 244 patients with pathologically diagnosed benign ovarian cysts (control group)in Women′s Hospital of Zhejiang University School of Medicine were retrospectively analyzed.The levels of coagulation indicators, inflammatory factors and serum tumor markers were measured. Then, the values of these indicators in diagnosis of endometriosis were analyzed. Results(1)The levels of plasma prothrombin time(PT)and thrombin time(TT)in patients with ovarian endometriosis [median 12.8 s (range12.4-13.2 s)and 15.5 s(range15.1-15.9 s),respectively]were significantly shorter than those with benign ovarian cysts[median13.0 s(range12.5-13.4 s)and 15.7 s(range15.3-16.1 s),respectively;all P<0.01].The levels of plasma fibrinogen(FIB)and D-dimer[D-D;median3.1 g/L(range2.8-3.5 g/L)and 0.9 mg/L(range0.6-2.1 mg/L),respectively]in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts[median2.8 g/L(range2.6-3.2 g/L)and 0.6 mg/L(range0.4-1.2 mg/L), respectively; P=0.000]. Moreover, neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio [PLR; median 2.3 (range 1.8-3.1) and 144 (range 113-179), respectively] in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts [median 2.1 (range 1.6-2.8) and 128 (range 104-165), respectively; P<0.01]. Furthermore, in patients with ovarian endometriosis, the levels of PT were significantly shorter in stage Ⅳ endometriosis than that in stage Ⅲ endometriosis (P<0.05).The levels of FIB and PLR in patients with stageⅣendometriosis were significantly higher than those in patients with stage Ⅲ endometriosis(P<0.01).(2)The cut-off value of CA125was 27.2 kU/L with a sensitivity of 83.6%,the cut-off value of FIB was 3.1 g/L with a sensitivity of 53.2%,while the sensitivity of combination index(FIB×CA125)was 84.9%.Conclusion The abnormality of coagulation and inflammatory factors may be involved in the pathogenesis of moderate and severe ovarian endometriosis,and the detection of coagulation and inflammatory factors may be have important clinical significance for the diagnosis and treatment of moderate and severe ovarian endometriosis.