Application value of transvaginal color doppler ultrasound combined with serum sFlt-1 and TIMP-1 in the differentiation of uterine fibroid and adenomyosis
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 our hospital were collected as the study subjects,including 93 patients with uterine fibroid and 67 patients with adenomyosis.Transvaginal color 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 of transvaginal 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%,and the specificity was 87.10%;the AUC of serum TIMP-1 level in differentiating uterine fibroid from adenomyosis was 0.86 the sensitivity was 64.18%,and the specificity was 93.55%.The results of transvaginal color doppler ultrasound showed that 82 of 93 patients with uterine fibroid were diagnosed and 11 were misdiagnosed;among 67 cases of adenomyosis,45 cases were diagnosed and 22 cases were misdiagnosed,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 good consistency 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 of combined 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.
LeiomyomaAdenomyosisTransvaginal color doppler ultrasoundSoluble fms-like tyrosine kinase 1Tissue inhib-itor of metalloproteinase-1
万方数据
维普
