Markers of deep infiltrating endometriosis in patients with ovarian endometrioma: a predictive model

被引:15
作者
Perello, Maria [1 ]
Martinez-Zamora, Maria A. [1 ]
Torres, Ximena [1 ]
Munros, Jordina [1 ]
Llecha, Silvia [1 ]
De lazzari, Elisa [2 ]
Balasch, Juan [1 ]
Carmona, Francisco [1 ]
机构
[1] Univ Barcelona, Clin Inst Gynecol Obstet & Neonatol, Hosp Clin, Barcelona, Spain
[2] Barcelona Ctr Int Hlth Res, CRESIB, Hosp Clin, Barcelona, Spain
关键词
Endometriosis; Ovarian endometrioma; Diagnosis; Prediction model; EAPP score; CLINICAL EXAMINATION; SERUM-LEVELS; DIAGNOSIS; DISEASE; SEVERITY; SURGERY;
D O I
10.1016/j.ejogrb.2015.11.024
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: The purpose of the study was to develop an easily applicable predictive model to predict deep infiltrating endometriosis in patients with ovarian endometrioma. Study design: We performed a retrospective analysis of 178 consecutive women with ovarian endometrioma who underwent surgery, with histological confirmation and complete removal of endometriosis in the Hospital Clinic of Barcelona. Several markers were prospectively obtained and compared between the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma and women with only ovarian endometrioma. Multiple logistic regression analysis was performed to create a model to predict the presence of deep infiltrating endometriosis and internal validation was later performed. Results: Of the 178 patients studied, 80 (45%) were classified in the ovarian endometrioma group and 98 (55%) in the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma. The independent variables to predict deep infiltrating endometriosis were: at least one previous pregnancy, a past history of surgery for endometriosis and the mean endometriosis-associated pelvic pain score. The area under the ROC curve was 0.91 (95% confidence interval: 0.86-0.94), with an optimal cut-off of the predicted probability of 0.54. The sensitivity of the model was 80% and the specificity 84%. Conclusions: This model predicts the development of deep infiltrating endometriosis in patients with ovarian endometriomas allowing prioritization of women for referral to specialized centers. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:55 / 60
页数:6
相关论文
共 29 条
[1]   Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis [J].
Abrao, Mauricio S. ;
Goncalves, Manoel Orlando da C. ;
Dias, Joao Antonio, Jr. ;
Podgaec, Sergio ;
Chamie, Luciana P. ;
Blasbalg, Roberto .
HUMAN REPRODUCTION, 2007, 22 (12) :3092-3097
[2]   NEW LOOK AT STATISTICAL-MODEL IDENTIFICATION [J].
AKAIKE, H .
IEEE TRANSACTIONS ON AUTOMATIC CONTROL, 1974, AC19 (06) :716-723
[3]  
Altman DG, 2000, STAT MED, V19, P453, DOI 10.1002/(SICI)1097-0258(20000229)19:4<453::AID-SIM350>3.0.CO
[4]  
2-5
[5]   Endometriomas as a marker of disease severity [J].
Banerjee, Saikat K. ;
Ballard, Karen D. ;
Wright, Jeremy T. .
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2008, 15 (05) :538-540
[6]   Mechanisms of Disease Endometriosis [J].
Bulun, Serdar E. .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (03) :268-279
[7]   Ovarian endometriosis: from pathogenesis to surgical treatment [J].
Busacca, M ;
Vignali, M .
CURRENT OPINION IN OBSTETRICS & GYNECOLOGY, 2003, 15 (04) :321-326
[8]   Ovarian endometrioma but not deep infiltrating endometriosis is associated with increased serum levels of interleukin-8 and interleukin-6 [J].
Carmona, Francisco ;
Chapron, Charles ;
Martinez-Zamora, Maria-Angeles ;
Santulli, Pietro ;
Rabanal, Aintzane ;
Martinez-Florensa, Mario ;
Lozano, Francisco ;
Balasch, Juan .
JOURNAL OF REPRODUCTIVE IMMUNOLOGY, 2012, 95 (1-2) :80-86
[9]   Does the learning curve of conservative laparoscopic surgery in women with rectovaginal endometriosis impair the recurrence rate? [J].
Carmona, Francisco ;
Martinez-Zamora, Angeles ;
Gonzalez, Xavier ;
Gines, Angeles ;
Bunesch, Laura ;
Balasch, Juan .
FERTILITY AND STERILITY, 2009, 92 (03) :868-875
[10]   Clinical Prediction of Deeply Infiltrating Endometriosis before Surgery: Is It Feasible? A Review of the Literature [J].
Carneiro, Marcia Mendonca ;
de Sousa Filogonio, Ivone Dirk ;
Pyramo Costa, Luciana Maria ;
de Avila, Ivete ;
Franca Ferreira, Marcia Cristina .
BIOMED RESEARCH INTERNATIONAL, 2013, 2013