NRP-1和CXCR4对卵巢子宫内膜异位囊肿患者妊娠结局的预测价值

doi:10.11958/20252959

天津医药 ›› 2026, Vol. 54 ›› Issue (4): 402-406.doi: 10.11958/20252959

NRP-1和CXCR4对卵巢子宫内膜异位囊肿患者妊娠结局的预测价值

冯小艳¹(), 张文倩¹, 方自红¹, 张广辉²^△()

¹ 新郑市公立人民医院妇科（邮编451100）
² 郑州工业应用技术学院医学院

收稿日期:2025-09-19 修回日期:2025-12-09 出版日期:2026-04-15 发布日期:2026-04-14
通讯作者: ^△E-mail：nursing840601@163.com
作者简介:冯小艳（1984），女，副主任医师，主要从事妇科微创手术方面研究。E-mail：ffvdz8@sina.com
基金资助:
河南省教育厅项目(24B310010)

Predictive value of NRP-1 and CXCR4 for pregnancy outcomes in patients with ovarian endometriotic cysts

FENG Xiaoyan¹(), ZHANG Wenqian¹, FANG Zihong¹, ZHANG Guanghui²^△()

¹ Department of Gynecology, Xinzheng Public People's Hospital, Xinzheng 451100, China
² Medical School, Zhengzhou Institute of Industrial Application Technology

Received:2025-09-19 Revised:2025-12-09 Published:2026-04-15 Online:2026-04-14
Contact: ^△E-mail：nursing840601@163.com

冯小艳, 张文倩, 方自红, 张广辉. NRP-1和CXCR4对卵巢子宫内膜异位囊肿患者妊娠结局的预测价值[J]. 天津医药, 2026, 54(4): 402-406.

FENG Xiaoyan, ZHANG Wenqian, FANG Zihong, ZHANG Guanghui. Predictive value of NRP-1 and CXCR4 for pregnancy outcomes in patients with ovarian endometriotic cysts[J]. Tianjin Medical Journal, 2026, 54(4): 402-406.

摘要/Abstract

摘要：

目的探究神经纤毛蛋白-1（NRP-1）、C-X-C基序趋化因子受体4（CXCR4）在卵巢子宫内膜异位囊肿（OEC）患者血清中的表达水平及对妊娠结局的预测价值。方法纳入OEC患者136例作为研究组，根据其随访期间是否妊娠分为妊娠组（84例）和未妊娠组（52例），另选取本院同期体检的育龄已婚的健康女性136例为对照组。多因素Logistic回归分析OEC患者未妊娠的影响因素；采用受试者工作特征（ROC）曲线分析血清NRP-1、CXCR4对妊娠结局的预测价值；决策曲线分析（DCA）确定联合检测对未妊娠的预测性能；绘制校准曲线评估模型的一致性。结果研究组血清血管内皮生长因子（VEGF）、NRP-1、CXCR4水平均较对照组高（P<0.05）。未妊娠组年龄、血清VEGF、NRP-1、CXCR4水平均较妊娠组高（P<0.05）。NRP-1、CXCR4、VEGF水平升高，年龄≥35岁是患者未妊娠的危险因素（P<0.05）。血清NRP-1、CXCR4单独及联合预测妊娠结局的曲线下面积（AUC）为0.764、0.776、0.870，二者联合优于各自单独预测（均P<0.05）。DCA显示，当高风险阈值在0.14~0.91时，联合预测妊娠结局的净获益率优于单独预测。H-L检验χ²=7.032，P=0.714，说明一致性较好。结论 OEC患者血清NRP-1、CXCR4水平升高，且与患者妊娠结局有关，早期检测对临床预测患者妊娠结局具有辅助作用，且联合检测的预测价值较高。

关键词: 子宫内膜异位症, 卵巢囊肿, 妊娠结局, 神经纤毛蛋白质1, 受体, CXCR4, 卵巢子宫内膜异位囊肿

Abstract:

Objective To explore the expression levels of serum neuropilin-1 (NRP-1) and C-X-C motif chemokine receptor 4 (CXCR4) in patients with ovarian endometriosis cysts (OEC) and their predictive value for pregnancy outcome. Methods A total of 136 OEC patients were included as the study group and were divided into the pregnancy group (84 cases) and the non-pregnancy group (52 cases) based on whether they were pregnant during follow-up period. Additionally, 136 healthy married women of reproductive age undergoing physical examinations at our hospital during the same period were selected as the control group. Multivariate Logistic regression analysis was used to identify factors influencing non-pregnancy in OEC patients. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of serum NRP-1 and CXCR4 for pregnancy outcome. Decision curve analysis (DCA) was performed to determine the predictive performance of combined detection for non-pregnancy, and calibration curves were drawn to assess the consistency of the model. Results The serum levels of vascular endothelial growth factor (VEGF), NRP-1 and CXCR4 were higher in the study group compared to those of the control group (P<0.05). In the non-pregnant group, age and serum levels of VEGF, NRP-1 and CXCR4 were higher compared to those of the pregnant group (P<0.05). The elevated levels of NRP-1, CXCR4 and VEGF were risk factors for non-pregnancy in patients aged ≥35 years (P<0.05). The area under the curve (AUC) of serum NRP-1 and CXCR4 alone and in combination for predicting pregnancy outcome was 0.764, 0.776 and 0.870, respectively. The combination of the two was superior to their individual predictions (P<0.05). The DCA results showed that when the high-risk threshold was between 0.14 and 0.91, the net benefit rate of joint prediction of pregnancy outcome was better than that of individual prediction. In addition, H-L test showed χ²=7.032, P=0.714, indicating good consistency. Conclusion OEC patients have elevated serum levels of NRP-1 and CXCR4, which are related to pregnancy outcome. Early detection can assist in clinically predicting patient pregnancy outcome, and the predictive value is higher when tested in combination.

Key words: endometriosis, ovarian cysts, pregnancy outcome, neuropilin-1, receptors, CXCR4, ovarian endometriosis cyst

中图分类号:

R711.71

图/表 9

参考文献 19

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组别	年龄		月经周期/d	VEGF/（ng/L）
组别	<35岁	≥35岁	月经周期/d	VEGF/（ng/L）
对照组	78（57.35）	58（42.65）	29.28±2.49	296.35±91.07
研究组	72（52.94）	64（47.06）	29.56±2.41	416.49±98.52
t或χ²	0.535		0.940	10.443^＊＊

组别	年龄		月经周期/d	VEGF/（ng/L）
组别	<35岁	≥35岁	月经周期/d	VEGF/（ng/L）
对照组	78（57.35）	58（42.65）	29.28±2.49	296.35±91.07
研究组	72（52.94）	64（47.06）	29.56±2.41	416.49±98.52
t或χ²	0.535		0.940	10.443^＊＊

组别	NRP-1/（μg/L）	CXCR4/（pg/L）
对照组	18.09±3.93	22.42±5.09
研究组	25.60±6.05	31.37±7.14
t	12.142^＊＊	11.915^＊＊

组别	NRP-1/（μg/L）	CXCR4/（pg/L）
对照组	18.09±3.93	22.42±5.09
研究组	25.60±6.05	31.37±7.14
t	12.142^＊＊	11.915^＊＊

组别		n		年龄							月经周期/d
组别		n		<35岁				≥35岁			月经周期/d
妊娠组		84		52（61.90）				32（38.10）			29.52±2.39
未妊娠组		52		20（38.46）				32（61.54）			29.62±2.43
t或χ²				7.085^＊＊							0.216
组别	囊肿侧别						囊肿直径/cm			VEGF/（ng/L）
组别	左侧				右侧		囊肿直径/cm			VEGF/（ng/L）
妊娠组	41（48.81）				43（51.19）		3.77±1.20			359.44±91.76
未妊娠组	27（51.92）				25（48.08）		3.92±1.20			508.65±102.39
t或χ²	0.125						0.706			8.813^＊＊
组别			R-AFS分期						剧烈痛经
组别			Ⅰ—Ⅱ			Ⅲ—Ⅳ			剧烈痛经
妊娠组			59（70.24）			25（29.76）			20（23.81）
未妊娠组			29（55.77）			23（44.23）			14（26.92）
t或χ²			2.944						0.166

NRP-1和CXCR4对卵巢子宫内膜异位囊肿患者妊娠结局的预测价值

Predictive value of NRP-1 and CXCR4 for pregnancy outcomes in patients with ovarian endometriotic cysts

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组别	n	NRP-1/（μg/L）	CXCR4/（pg/L）
妊娠组	84	22.64±5.37	27.69±5.74
未妊娠组	52	30.38±7.15	37.31±9.39
t		6.722^＊＊	6.659^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
NRP-1	0.917	0.349	6.899	0.009	2.501	1.262~4.957
CXCR4	1.056	0.395	7.143	0.007	2.874	1.325~6.233
年龄	0.701	0.278	6.360	0.012	2.016	1.169~3.476
VEGF	1.071	0.407	6.919	0.008	2.917	1.314~6.477
常数项	-9.210	2.631	12.255	<0.001	<0.001	-

变量	AUC	95%CI	敏感度/%	特异度/%	截断值
NRP-1	0.764	0.680~0.847	83.43	77.62	27.49 μg/L
CXCR4	0.776	0.695~0.858	86.02	75.88	33.86 pg/L
二者联合	0.870	0.807~0.933	91.29	73.56	-

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