Preoperative CA125 as a risk factor for symptom recurrence of adenomyosis after ultrasound-guided high-intensity focused ultrasound ablation surgery

Tang, Ying; Yang, Ming‐tao; Xiang, Rumei; Xu, Wei; Zhang, Ruoyi; Weng, Ming-Bo; Tang, Fang-Xiang; Hu, Huiquan; Xu, Fan; Li, Jun; Shi, Qiuling

doi:10.1080/02656736.2022.2107716

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…15 CA125, a marker of epithelial ovarian cancer, was significantly elevated in the adenomyosis patients than those diagnosed with uterine fibroids and some other gynecological benign diseases. 16,17 And earlier study also demonstrated that CA125 was positively correlated with PLT in adenomyosis. 18 Considering that CA125 may be related to the change of coagulation and the differential expression in adenomyosis, uterine fibroids, and other gynecological diseases, we conducted a cross-sectional study to determine the changes in coagulation parameters (PLT, PT, APTT, TT, FIB (plasma fibrinogen) and INR (international normalized ratio)) in patients with adenomyosis as compared to patients with uterine fibroids and patients with cervical intraepithelial neoplasia (CIN)-III who underwent cervical conization or hysterectomy.…”

Section: Introductionmentioning

confidence: 77%

CA125-Associated Activated Partial Thromboplastin Time and Thrombin Time Decrease in Patients with Adenomyosis

Yang,

Wang,

et al. 2024

JMDH

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Adenomyosis patients are in a hypercoagulable state, and studies have shown that carbohydrate antigen125 (CA125) may relate to the hypercoagulability and thrombosis of patients with adenomyosis, but there is still a lack of clarity regarding the changes in CA125-related coagulation indicators. This study was to explore the changes and influencing factors of CA125-related coagulation parameters in patients with adenomyosis. Methods: Retrospective observational study conducted on 200 patients with adenomyosis (AM group), 240 patients with uterine leiomyoma (LM group) and 81 patients with cervical intraepithelial neoplasia (CIN)-III (control group), of which the coagulation parameters were detected by clinical blood sample collection and statistical method analysis and informed consent was obtained. Results:The level of CA125 in the AM group was significantly higher than that in the LM group and control group. However, thrombin time (TT) shortened in the AM group when compared with the LM and control group. Activated partial thromboplastin time (APTT) in the AM group was shorter than in the control group. Multivariate logistic regression analysis found that adenomyosis was associated with CA125 level (OR=323.860, 95% CI 90.424-1159.924, P<0.001), APTT (OR=1.295, 95% CI 1.050-1.598, P=0.016), TT (OR=0.642, 95% CI 0.439-0.938, P=0.022), menorrhagia (OR=7.363, 95% CI 2.544-21.315, P<0.001), dysmenorrhea (OR=22.590, 95% CI 8.185-62.347, P<0.001). Correlation analysis revealed that APTT (r= −0.207) and TT (r = −0.174) were negatively correlated with the level of CA125. Conclusion:The shortening of CA125-related APTT and TT indicates that it is meaningful to detect coagulation parameters of patients with elevated CA125 levels early, dysmenorrhea and menorrhagia, and maybe further discover the hypercoagulability and prevent the occurrence of thrombus in adenomyosis.

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Section: Introductionmentioning

confidence: 77%

CA125-Associated Activated Partial Thromboplastin Time and Thrombin Time Decrease in Patients with Adenomyosis

Yang,

Wang,

et al. 2024

JMDH

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“…The inclusion criteria were: patients with dysmenorrhea or menorrhagia eligible for ultrasound‐guided FUAS; those with complete basic clinical information and FUAS parameters (from medical records); those who underwent MRI within 1 month before FUAS; and those who were willing to be followed up after FUAS 10 . The exclusion criteria were: patients ineligible for ultrasound‐guided FUAS; those with incomplete basic information and FUAS parameters from medical records; those with no MRI before FUAS 10 ; those with a history of medicine for dysmenorrhea, which might impact the evaluation of FUAS outcomes within 6 months before FUAS 11 ; those with concomitant uterine fibroids, deep endometriosis, or malignant tumors on MRI; and those who refused follow‐up after FUAS.…”

Section: Methodsmentioning

confidence: 99%

Magnetic Resonance Imaging‐Based Classification Systems for Informing Better Outcomes of Adenomyosis After Ultrasound‐Guided High‐Intensity Focused Ultrasound Ablating Surgery

Tang,

Hu,

Wang

et al. 2023

Magnetic Resonance Imaging

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BackgroundA referenced MRI‐based classification associated with focused ultrasound ablation surgery (FUAS) outcomes is lacking in adenomyosis.PurposeTo identify an MRI‐based classification system for informing the FUAS outcomes.Study TypeRetrospective.PopulationPatients with FUAS for adenomyosis, were divided into a training set (N = 643; 355 with post‐FUAS gonadotropin‐releasing hormone/levonorgestrel, 288 without post‐FUAS therapy) and an external validation set (N = 135; all without post‐FUAS therapy).Field Strength/Sequence1.5 T, turbo spin‐echo T2‐weighted imaging and single‐shot echo‐planar diffusion‐weighted imaging sequences.AssessmentFive MRI‐based adenomyosis classifications: classification 1 (C1) (diffuse, focal, and mild), C2 (intrinsic, extrinsic, intramural, and indeterminate), C3 (internal, adenomyomas, and external), C4 (six subtypes on areas [internal or external] and volumes [<1/3 or ≥2/3]), and C5 (internal [asymmetric or symmetric], external, intramural, full thickness [asymmetric or symmetric]) for FUAS outcomes (symptom relief and recurrence).Statistical TestsThe optimal classification was significantly associated with the most subtypes of FUAS outcomes. Relating to the timing of recurrence was measured using Cox regression analysis and median recurrence time was estimated by a Kaplan–Meier curve. A P value <0.05 was considered statistically significant.ResultsDysmenorrhea relief and recurrence were only associated with C2 in training patients undergoing FUAS alone. Compared with other subtypes, the extrinsic subtype of C2 was significantly associated with dysmenorrhea recurrence in the FUAS group. Besides, the median dysmenorrhea recurrence time of extrinsic subtype was significantly shorter than that of other subtypes (42.0 months vs. 50.3 months). In the validation cohort, C2 was confirmed as the optimal system and its extrinsic subtype was confirmed to have a significantly shorter dysmenorrhea recurrence time than other subtypes.Data ConclusionClassification 2 can inform dysmenorrhea relief and recurrence in patients with adenomyosis undergoing FAUS only. Itsextrinsic subtype was associated with an earlier onset of dysmenorrhea recurrence after treatment.Evidence Level3Technical EfficacyStage 5

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“…Hence, hysterectomy is considered the optimal option for women with adenomyosis, except for those who would like to preserve fertility. As a non-invasive technique, focused ultrasound ablation surgery (FUAS) has become a popular option for patients with adenomyosis, especially for those who hope to preserve fertility 3 . Previous studies have shown that FUAS is a safe and effective treatment for adenomyosis [2][3][4] ; however, dysmenorrhea and/or menorrhagia may relapse in 12 months after treatment 4 .…”

Section: Introductionmentioning

confidence: 99%

“…As a non-invasive technique, focused ultrasound ablation surgery (FUAS) has become a popular option for patients with adenomyosis, especially for those who hope to preserve fertility 3 . Previous studies have shown that FUAS is a safe and effective treatment for adenomyosis [2][3][4] ; however, dysmenorrhea and/or menorrhagia may relapse in 12 months after treatment 4 . Several predisposing factors, such as phenotypes and morphological characteristics, have been reported to be potentially associated with either FUAS efficacy or symptom recurrence after FUAS, nevertheless few of them were proved to be clinically applicable [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Identification of an optimal magnetic resonance imaging-based classification for evaluating efficacy of ultrasound-guided high-intensity focused ultrasound

Tang

Xiao²,

Wen³

et al. 2022

Preprint

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Objective: To identify an optimal magnetic resonance imaging-based classification for evaluating the efficacy of focused ultrasound ablation surgery (FUAS). Design：A retrospective cohort study. Setting: The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, China. Population: A total of 643 adenomyosis patients who received FUAS from June 2017 to December 2021. Methods: One-way ANOVA test and chi square test were used to identify an optimal classification for evaluating FUAS efficacy. Magnitude of the optimal classification relating to timing of recurrence in FUAS group was measured by cox regression with hazard ratio (HR) and 95% CI. K-M curve was applied to estimate the medium recurrence time of adenomyosis in the optimal classification. Main outcome measures: The identification of different classifications for FUAS efficacy and the factors contributing to recurrence after FUAS. Results: The rates of dysmenorrhea relief (χ2=10.079, P=0.018) and recurrence could be identified by classification 2 in FUAS group (χ2=10.582, P=0.014), but not in FUAS+ group (P＞0.05). Besides, the recurrence rate in FUAS group (22.2.0%) was higher than that in FUAS+ group (12.1%). Extrinsic subtype in classification 2 (HR=2.315, 95% CI 1.219～4.560, P=0.011) correlated to recurrence of adenomyosis in FUAS group. K-M curve showed that the medium recurrence time of extrinsic subtype (45.2 months) was shorter than that of other subtypes (52.0 months). Conclusions: Classification 2 was the optimal one to identify the rates of dysmenorrhea relief and recurrence. Extrinsic subtype was related to the earlier onset of recurrence after FUAS.

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Preoperative CA125 as a risk factor for symptom recurrence of adenomyosis after ultrasound-guided high-intensity focused ultrasound ablation surgery

Cited by 9 publications

References 25 publications

CA125-Associated Activated Partial Thromboplastin Time and Thrombin Time Decrease in Patients with Adenomyosis

CA125-Associated Activated Partial Thromboplastin Time and Thrombin Time Decrease in Patients with Adenomyosis

Magnetic Resonance Imaging‐Based Classification Systems for Informing Better Outcomes of Adenomyosis After Ultrasound‐Guided High‐Intensity Focused Ultrasound Ablating Surgery

Identification of an optimal magnetic resonance imaging-based classification for evaluating efficacy of ultrasound-guided high-intensity focused ultrasound

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