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| Value of transvaginal ultrasound combined with the levels of serum vascular endothelial growth factor A and cysteine rich protein 61 for differential diagnosing adenomyosis of patients |
| The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, 075000 |
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Abstract To explore the value of transvaginal ultrasound (TVUS) combined with the levels of serum vascular endothelial growth factor A (VEGF-A) and cysteine rich protein 61 (Cyr61) for differential diagnosing adenomyosis (AM) of patients. Methods: A total of 106 patients with AM in study group were selected and were divided in group A (49 cases in the proliferative phase) and group B (57 cases in the secretory phase) according to the different stage of AM of the patients from June 2020 to November 2023. In addition, 106 patients with uterine fibroids were selected in control group during the same period. The patients in these groups were given transvaginal ultrasound (TVUS) examination. The serum VEGF-A and Cyr61 levels of the patients in these groups were detected. Multiple factor logistic regression analysis was used to analyze the factors that affected the occurrence of AM of the patients. Receiver operating characteristic (ROC) curve was used to analyze the value of TVUS combined with serum VEGF-A and Cyr61 levels of the patients for diagnosing their AM occurrence. Results: A total of 96 (90.6%) patients with AM were detected by TVUS. The levels of serum VEGF-A (195.24±55.68 pg/ml) and Cyr61 (241.34±71.52μg/L) of the patients in the study group were significantly higher than those (143.57±37.35 pg/ml and 172.59±46.88μg/L) of the patients in the control group. The levels of serum VEGF-A and Cyr61 of the patients in group A were significantly higher than those of the patients in group B. The values of the maximum velocity of blood flow in diastole, the maximum velocity of blood flow in systole, the resistance index of blood flow and the pulsatility index of blood flow around the lesion by TVUS examination of the patients in the study group were significantly higher than those of the patients in the control group (all P<0.05). Multivariate analysis showed that the increase of the serum VEGF-A and Cyr61 levels of the patients were the risk factors of their AM occurrence (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the TVUS, the VEGF-A level, the Cyr61 level, and the combination of the TVUS and the VEGF-A and Cyr61 levels of the patients for diagnosing their AM occurrence were 0.533, 0.769, 0.799 and 0.860, respectively. The AUC of the combined TVUS and the VEGF-A and Cyr61 levels of the patients for diagnosing their AM occurrence were the highest (Z=11.314, 2.999, 2.832, all P<0.05). Conclusion: The levels of VEGF-A and Cyr61 of the patients with AM increase. The TVUS examination combined with the VEGF-A and Cyr61 levels of the patients can improve the differential diagnosis value of their AM.
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