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

doi:10.11958/20252959

Abstract

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

CLC Number:

R711.71

Figures/Tables 9

References 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