Objective To investigate the value of transvaginal color Doppler ultrasound (TVCDS) combined with peripheral blood hemoglobin (Hb), neutrophil-to-lymphocyte ratio (NLR), serum tissue inhibitory factor of metalloproteinase 1 (TIMP-1), and soluble fms-like tyrosine kinase-1 (sFlt-1) in differential diagnosis of uterine fibroids (UF) and adenomyosis (Am). Methods 143 cases of patients with pathologically confirmed UF and Am admitted to the First People's Hospital of Zigong from June 2023 to May 2024 were selected. They were divided into the UF group (81 cases) and Am group (62 cases). The clinical data, including peripheral blood Hb, NLR, serum TIMP-1 and sFlt-1 were compared between the two groups. The risk factors of Am, the value of levels of peripheral blood Hb, NLR, serum TIMP-1 and sFlt-1 for the differential diagnosis of UF and Am, and the diagnostic value of TVCDS combined with these four indicators in distinguishing UF from AMS were analyzed. Results The proportion of dysmenorrhea, prolonged menstruation, levels of peripheral blood NLR, serum TIMP-1 and sFlt-1 were higher than the UF group, level of peripheral blood Hb was lower than the UF group. Multivariate Logistic regression analysis showed that dysmenorrhea, prolonged menstrual period, peripheral blood Hb, NLR, serum TIMP-1 and sFlt-1 were independent risk factors for Am. ROC analysis showed that the area under the curve (AUC) values for differential diagnosis of UF and Am at levels of peripheral blood Hb, NLR, serum TIMP-1, and sFlt-1 were 0.743, 0.842, 0.746, and 0.850. The sensitivity and accuracy of combined detection of TVCDS, peripheral blood Hb, NLR, serum TIMP-1 and sFlt-1 in the differential diagnosis of UF and Am were higher than those of single detection of each index; the sensitivity of TVCDS alone was higher than that of serum TIMP-1 and sFlt-1, and the accuracy was higher than that of peripheral blood Hb, NLR and serum TIMP-1; the specificity of sFlt-1 alone was higher than that of peripheral blood Hb, NLR and serum TIMP-1, and the accuracy was higher than that of serum TIMP-1. Conclusion TVCDS combined with peripheral blood Hb, NLR, serum TIMP-1, sFlt-1 was more advantageous for the differential diagnosis of UF and Am.
Key words
uterine fibroids /
adenomyosis /
transvaginal color Doppler ultrasound /
multiparameter combined diagnosis
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References
[1] SĂSĂRAN V, TURDEAN S, GLIGA M, et al. Value of strain-ratio elastography in the diagnosis and differentiation of uterine fibroids and adenomyosis[J]. J Pers Med, 2021, 11(8): 824.
[2] PATETTA MA, GRIFFITH KN, WALKER JA, et al.National utilization trends of inpatient procedures for symptomatic uterine fibroids and adenomyosis: a 10-year analysis[J]. J Am Coll Radiol, 2025, 22(4): 417-424.
[3] PONGPUNPRUT S, PANBURANA P, WIBULPOLPRASERT P, et al.A comparison of shear wave elastography between normal myometrium, uterine fibroids, and adenomyosis: a cross-sectional study[J]. Int J Fertil Steril, 2022, 16(1): 49-54.
[4] 韦洁勤. MRI多模态技术对子宫肌瘤及子宫腺肌症MRgFUS治疗的疗效评估价值[D]. 南宁: 广西医科大学, 2022.
[5] 许昌翠, 徐燕红, 殷广莉, 等. 经阴道与经腹部彩色多普勒超声对子宫肌瘤及子宫腺肌病的鉴别诊断[J]. 中国实验诊断学, 2022, 26(1): 50-54.
[6] 胡咏霞, 沈宏雯. 经阴道彩超联合血清HE4对子宫腺肌病与子宫肌瘤的鉴别价值分析[J]. 中国妇幼保健, 2025, 40(1): 172-176.
[7] 黄佳慧, 周青, 张诺彬. 血清NLR、Hb、CA125及CA199的检测对子宫肌瘤合并子宫腺肌症的鉴别诊断及预后评估的价值[J]. 贵州医科大学学报, 2023, 48(12): 1551-1555.
[8] 师凌云, 张佩雪, 高冬霞, 等. 子宫内膜异位症患者血清sICAM-1、TIMP-1水平及其诊断意义[J]. 中国计划生育学杂志, 2022, 30(9): 2098-2101.
[9] 吴玉良, 吴春玲, 吴丹. 血清sFLT1、CTRP3水平与子宫内膜异位症的相关性[J]. 实用医学杂志, 2023, 39(14): 1798-1803.
[10] 谢幸, 孔北华, 段涛. 妇产科学 (第9版)[M]. 北京: 人民卫生出版社, 2018: 33-41.
[11] STOELINGA B, JUFFERMANS L, DOOPER A, et al.Contrast-enhanced ultrasound imaging of uterine disorders: a systematic review[J]. Ultrason Imaging, 2021, 43(5): 239-252.
[12] 王洁, 段娜, 王绍娟, 等. 子宫性不孕的多参数MRI、MR-HSG及临床特征分析[J]. 磁共振成像, 2024, 15(3): 122-129.
[13] 宣锦瑜. 经腹与经阴道彩色多普勒超声在子宫肌瘤和子宫腺肌病鉴别诊断中的效果观察[J]. 中国妇幼保健, 2024, 39(17): 3439-3442.
[14] 戴爱丽, 周全. 经阴道彩色多普勒超声结合血清CA199鉴别诊断子宫肌瘤与子宫腺肌症[J]. 中国计划生育学杂志, 2022, 30(5): 1150-1153, 1212.
[15] 张丽玲. 经阴道彩色多普勒超声诊断子宫肌瘤、腺肌症及腺肌瘤的临床价值[J]. 中国现代药物应用, 2022, 16(7): 71-73.
[16] 王文娟, 王智霆, 庄亚琼, 等. 子宫肌瘤并子宫腺肌症的相关影响因素临床分析[J]. 临床误诊误治, 2020, 33(5): 80-85.
[17] 宋宏, 尚小巧, 田宏. 血清IL-8、TIMP-1、单核细胞趋化因子-1在子宫内膜异位症中的表达及与疾病分期的关系[J]. 实验与检验医学, 2022, 40(3): 298-301, 305.
[18] 汪佳, 沙敏, 葛红山, 等. 外周血MMP-9和sFlt-1水平对子宫内膜异位症患者月经周期的影响[J]. 河北医学, 2021, 27(8): 1275-1279.
[19] 丁玲, 徐琳, 窦舒兰. 中性粒细胞与淋巴细胞比值联合血红蛋白水平预测子宫肌瘤并子宫腺肌症价值分析[J]. 河北医科大学学报, 2022, 43(1): 54-57, 64.
[20] 许立云, 刘翠霞, 徐连芸, 等. 经阴道彩色多普勒超声结合血清sFlt-1、TIMP-1在鉴别子宫肌瘤与子宫腺肌症中的应用价值[J]. 安徽医药, 2025, 29(2): 358-362.
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