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| Correlation between the levels of the preoperative serum CXC-class chemokine ligand 12 and CXC-class chemokine receptor 4 of patients with endometrial polyps and their intrauterine adhesions after the endometrial polypectomy |
| 1.The Fifth People's Hospital of Wuxi, Wuxi, Jiangsu Province, 214000；2.Lianyungang Maternal and Child Health Care Hospital；3.Nanjing Brain Hospital |
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Abstract To correlation between the levels of the preoperative serum CXC-class chemokine ligand 12 (CXCL12) and CXC-class chemokine receptor 4 (CXCR4) of patients with endometrial polyps and their intrauterine adhesions after the endometrial polypectomy. Methods: The clinical data of 86 patients who had undergone hysteroscopic cold knife resection of endometrial polyps from January 2021 to January 2023 were selected in this study. These patients were divided into group A (33 cases with intrauterine adhesion) and group B (53 cases without intrauterine adhesion) according to the results of the follow-up in the postoperative 1 year. The serum CXCL12 and CXCR4 levels of the patients in the two groups were detected within 24h after admission. Receiver operating characteristic (ROC) curve was used to evaluate the value of the serum CXCL12 and CXCR4 levels of the patients for their intrauterine adhesion after polypectomy. Binary logistic stepwise regression was used to analyze the related factors of the postoperative adhesion of the patients. Results: The operation time, the gravidity, the history of cesarean section, the history of curettage, the proportion of intrauterine device used, the history of pelvic inflammatory disease, the proportion of endometrial hyperplasia and the polyp diameter of the patients in group A were significantly higher than those of the patients in group B (P<0.05). The levels of preoperative serum CXCL12 (11.47±2.84pg/L) and CXCR4 (50.61±10.02pg/L) of the patients in group A were significantly higher than those (5.66±1.24pg/L and 23.26±5.69pg/L) of the patients in group B (all P<0.05). ROC curve analysis showed that the area under the curve of the preoperative serum CXCL12 level, the CXCR4 level and the combination of the CXCL12 and CXCR4 levels of the patients with endometrial polyps for evaluating the occurrence of their intrauterine adhesion after the polyp’s resection were 0.854, 0.866 and 0.925, respectively. Binary logistic stepwise regression analysis showed that the multiple pregnancies, the history of curettage, the pelvic inflammatory disease and the increased serum CXCL12 and CXCR4 levels of the patients were the risk factors of their intrauterine adhesion after the resection of endometrial polyps (all P<0.05). Conclusion: The serum CXCL12 and CXCR4 levels of the patients with endometrial polyps before endometrial polyp resection increase, which can be the risk factors of the postoperative intrauterine adhesions. The combination of the serum CXCL12 and CXCR4 levels of the patients has better diagnostic efficacy for the occurrence of their intrauterine adhesions after the resection of the endometrial polyp.
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