Risk Factors and Model Prediction of Recurrence After Hysteroscopy Resection of Endometrial Polyps
Objective To investigate the factors influencing recurrence after hysteroscopic resection of endometrial polyps(EP)and model prediction.Methods A total of 150 EP patients who received hysteroscopic resection in the Third Affiliated Hospital of Zhengzhou University from September 2018 to September 2021 were selected,and one year after surgery was taken as the observation end point,and 30 patients with recurrence were included in the recurrence group,and the remaining 120 patients were included in the non-recurrence group.General clinical data and expressions of MMP-9/TIMP-1,HIF-1α and PDGF in endometrial tissues of the two groups were collected.The independent influencing factors of relapse after EP hysteroscope resection were analyzed by univariate and logistic multivariate analysis,and a nomogram prediction model for recurrence risk was constructed.Receiver operating characteristic(ROC)curve,calibration curve and clinical benefit(DCA)curve were plotted to evaluate the differentiation,consistency and clinical benefit of the model.Results Body mass index(BMI)of patients in the relapse group,number of abortion,number of polyps,proportion of endometritis,proportion of polycystic ovary syndrome(PCOS),proportion of hysteroscope resection and endometrial tissue matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1(MMP-9/TIMP-1),Hypoxia inducible factor-1 α(HIF-1α),platelet derived growth factor(PDGF)mRNA expression were higher than in not relapse group,and the difference was statistically significant(P＜0.05).BMI,number of abortions,number of polyps,endometritis,PCOS,hysteroscopic resection and endometrial tissue MMP-9/TIMP-1,HIF-1α,PDGF were independent risk factors for recurrence after hysteroscopic resection in EP patients,and the difference was statistically significant(P＜0.05).The area under the curve(AUC)of EP patients predicted after hysteroscopic resection was 0.918(95％CI=0.846-0.990),the Hosmer-Lemeshow excellence of fit test was 7.682,P=0.315,and the slope of the calibration curve for predicting postoperative recurrence was close to 1.The DCA curve shows that the model has obvious positive net benefit.Conclusion BMI,number of miscarriages,number of polyps,endometritis,PCOS,hysteroscopic electrodesiccation,MMP-9/TIMP-1,HIF-1 α and PDGF are independent risk factors for recurrence after hysteroscopic resection in EP patients,and a column-line prediction model was constructed based on the above factors,which was effective in predicting the risk of recurrence after hysteroscopic resection of EP,and has good clinical utility.
万方数据
维普
