Journal of Obstetrics and Gynaecology Research最新文献_第4页

Can maternal serum soluble fms-like tyrosine kinase-1 to placental growth factor levels at term anticipate adverse pregnancy outcomes? 足月母体血清可溶性样酪氨酸激酶-1与胎盘生长因子水平是否能预测不良妊娠结局？

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-02 DOI: 10.1111/jog.16191

Sarah A. Corker, Thomas J. Cade, Shaun P. Brennecke

Aim

To evaluate if maternal serum soluble fms-like tyrosine kinase-1(sFlt-1) to placental growth factor (PlGF) ratio levels at term can anticipate the following adverse pregnancy outcomes: small for gestational age neonates; operative delivery for suspected fetal welfare compromise; and neonatal compromise.

Methods

A retrospective analysis of a single hospital database containing antenatal soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) ratio results together with associated demographic, clinical and investigative information. Subjects with antenatal sFlt-1/PlGF measurements taken ≥37 weeks' gestation were analyzed. sFlt-1/PlGF ratio cut-offs of <38, 38–110, 111–201 and >201 were tested against the following outcomes: birthweight ≤10th and ≤3rd centiles; operative delivery for suspected fetal welfare compromise; 5 min Apgar score; and neonatal admissions for extra care.

Results

Statistically significant associations were found between sFlt-1/PlGF ratios 111–201 and birthweights ≤10th centile (p < 0.01, odds ratio [OR] 3.04, 95% confidence interval [CI] 1.52–6.10), and between operative delivery for suspected fetal welfare compromise and sFlt-1/PlGF ratios 111–201 (p = 0.04, OR 2.21, 95% CI 1.03–4.75) and >201 (p = 0.01, OR 4.73, 95% CI 1.45–15.4).

Conclusions

This study indicates that maternal serum sFlt-1/PlGF ratios performed at term may subsequently help identify significantly small-for-gestational age fetuses and operative delivery for suspected fetal welfare compromise. Further prospective studies may confirm these findings and substantiate the clinical importance of sFlt-1/PlGF measurements in assisting the management of pregnancies at term.

目的：评估临产时母体血清可溶性瘤样酪氨酸激酶-1（sFlt-1）与胎盘生长因子（PlGF）的比值是否能预测以下不良妊娠结局：胎龄偏小的新生儿；因怀疑胎儿福利受损而进行的手术分娩；以及新生儿受损：方法：对包含产前可溶性酪氨酸激酶-1与胎盘生长因子（sFlt-1/PlGF）比值结果以及相关人口学、临床和检查信息的单个医院数据库进行回顾性分析。对妊娠≥37周时进行产前sFlt-1/PlGF测量的受试者进行了分析。sFlt-1/PlGF比值临界值201与以下结果进行了测试：出生体重≤第10百分位数和≤第3百分位数；因怀疑胎儿福利受损而进行的手术分娩；5分钟Apgar评分；新生儿入院接受额外护理：结果：发现sFlt-1/PlGF比率111-201与出生体重≤10百分位数（p 201 (p = 0.01, OR 4.73, 95% CI 1.45-15.4)）之间有统计学意义：这项研究表明，在足月时进行的母体血清sFlt-1/PlGF比值随后可帮助识别明显小于胎龄的胎儿，并在怀疑胎儿福利受损时进行手术分娩。进一步的前瞻性研究可能会证实这些发现，并证实sFlt-1/PlGF测量在协助足月妊娠管理方面的临床重要性。

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引用次数: 0

Prolonged prothrombin time in hyperemesis gravidarum as an indicator of vitamin K deficiency 妊娠剧吐凝血酶原时间延长作为维生素K缺乏的指标。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-02 DOI: 10.1111/jog.16198

Nozomi Ouchi, Yoshimitsu Kuwabara, Mirei Yonezawa, Jun Ogawa, Sayuri Kasano, Masahiko Kato, Ryuhei Kurashina, Tomoko Ichikawa, Ikuno Kawabata, Shunji Suzuki

Aim

Maternal vitamin K (VK) deficiency can lead to fetal complications such as cerebral hemorrhage and bone malformations. In this study, we aimed to analyze changes in prothrombin time (PT) and protein induced by VK absence or antagonist II (PIVKA-II) in patients with severe hyperemesis gravidarum with suspected VK deficiency.

Methods

We compared 151 patients with severe hyperemesis gravidarum treated with intravenous nutrition to 46 patients undergoing cervical suturing or benign ovarian tumor surgery before mid-pregnancy.

Results

In the hyperemesis group, coagulation factors, including PT (s), prothrombin activity, INR, and APTT, showed a significant shift toward fibrinolysis compared to control (p < 0.001). The changes were within the normal range, except for PT (s), which was prolonged (14.6 ± 1.4 s). PIVKA-II was measured 25 times in 11 cases of hyperemesis and significantly correlated with PT (s). Moreover, VK was supplemented in four cases with severe VK deficiency, promptly normalizing both PT (s) and PIVKA-II.

Conclusions

Monitoring VK deficiency using PT (s) and PIVKA-II, with timely VK supplementation, may help prevent fetal complications in severe hyperemesis gravidarum.

目的：母体维生素K （VK）缺乏可导致胎儿并发症，如脑出血和骨骼畸形。在本研究中，我们旨在分析怀疑VK缺乏的严重妊娠剧吐患者凝血酶原时间（PT）和蛋白的变化。方法：将151例经静脉营养治疗的重度妊娠剧吐患者与46例妊娠中期前行宫颈缝合或卵巢良性肿瘤手术的患者进行比较。结果：在剧吐组中，凝血因子，包括PT (s)、凝血酶原活性、INR和APTT，与对照组相比，显示出纤溶的显著转变(p结论：使用PT (s)和PIVKA-II监测VK缺乏，及时补充VK，可能有助于预防严重妊娠剧吐的胎儿并发症。

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引用次数: 0

Correlation between the 5-tier fetal heart rate pattern classification at delivery and Apgar scores 分娩时5级胎儿心率模式分类与Apgar评分的相关性。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-30 DOI: 10.1111/jog.16199

Mariko Watanabe, Norikazu Watanabe, Mika Fukase, Keiko Yamanouchi, Satoru Nagase

Aim

In Japan, the fetal heart rate pattern on cardiotocography is usually categorized into five levels for intrapartum management; however, studies on the 5-tier cardiotocography classification are limited. This study aimed to determine the correlation between 5-tier cardiotocography levels at delivery, neonatal Apgar scores and perinatal prognosis using a perinatal registry database.

Methods

This retrospective study used the 2018 Perinatal Registry Database of the Japan Society of Obstetrics and Gynecology. Apgar scores and perinatal prognosis were compared between patients with Japan Society of Obstetrics and Gynecology intrapartum cardiotocography levels 1–2, and levels 3–5.

Results

In total, 240 987 cases were registered, with 114 201 full-term deliveries comprising 84 703 vaginal and 29 498 cesarean deliveries. For vaginal delivery cases, the crude odds ratios of 1-min Apgar score ≤3 for levels 3 (odds ratio: 1.7, 95% confidence interval: 1.4–2.0, p < 0.0001), levels 4 (odds ratio: 5.9, 95% confidence interval: 5.1–6.9, p < 0.0001), and levels 5 (odds ratio: 49.2, 95% confidence interval: 37.5–64.5, p < 0.0001) were significantly higher than those for levels 1–2 (odds ratio: 1.0). Moreover, the crude odds ratios of 5-min Apgar score ≤ 3 for levels 4 (odds ratio: 4.8, confidence interval: 2.7–8.7, p < 0.0001), and levels 5 (odds ratio: 71.1, confidence interval: 32.6–155.1, p < 0.0001) were significantly higher than those for levels 1–2 (odds ratio: 1.0). Similarly, in cases of cesarean delivery, it showed a similar trend to case of vaginal delivery cases.

Conclusion

The 5-tier cardiotocography classification can predict severe neonatal asphyxia.

目的：在日本，通常将胎心摄影上的胎儿心率模式分为五个级别，用于分娩时的管理；然而，关于5层心脏造影分类的研究有限。本研究旨在通过围产期登记数据库确定分娩时5级心血管造影水平、新生儿Apgar评分和围产期预后之间的相关性。方法：采用日本妇产科学会2018年围产期登记数据库进行回顾性研究。比较日本妇产学会分娩期心脏造影分级1-2级和3-5级患者的Apgar评分和围产儿预后。结果：共登记240 987例，足月分娩114 201例，其中阴道分娩84 703例，剖宫产29 498例。对于阴道分娩病例，3级1 min Apgar评分≤3的粗优势比（优势比：1.7,95%可信区间：1.4 ~ 2.0,p）结论：5级心脏科分级可预测新生儿重度窒息。

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引用次数: 0

Tadalafil suppresses LPS-induced inflammation and improves pregnancy outcomes in a pregnant mouse model

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-29 DOI: 10.1111/jog.16196

Kento Yoshikawa-Terada, Erina Takayama, Midori Uemura, Kuniaki Toriyabe, Ryota Tachibana, Hideaki Yajima, Tomoaki Ikeda, Eiji Kondo, Hiroki Takeuchi

Aim

This study investigated the efficacy of tadalafil in reducing inflammation and improving pregnancy outcomes in an lipopolysaccharide (LPS)-induced mouse model of perinatal complications.

Methods

Pregnant C57BL/6J mice were divided into three groups: control (C), LPS (L), and LPS + tadalafil (LT). The LT group received tadalafil from 10 days post-coitum (dpc), and LPS was administered intraperitoneally to the L and LT groups at 11 dpc. Mice were sacrificed 2 h post-injection for inflammatory marker analysis, with plasma and placentas collected. Remaining mice were sacrificed at 14 dpc to assess miscarriage and FGR. Placental damage was scored, cytokine levels measured by ELISA, and TNFα and NF-κB expression examined via immunohistochemistry.

Results

Fetal weight was significantly lower in the L and LT groups compared to the C group, with the LT group showing a significant increase compared to the L group. Absorption rates were significantly higher in the L group compared to the C and LT groups. At 14 dpc, placental necrosis scores were significantly higher in the L and LT groups than in the C group, while the LT group showed a significant decrease compared to the L group. Plasma inflammatory cytokine levels (TNF-α, IL-1β, IL-6) were significantly elevated following LPS administration but reduced with tadalafil treatment. Additionally, TNF-α expression and NF-κB activity in the placenta were significantly higher in the L group compared to the C and LT groups.

Conclusions

Tadalafil reduced inflammation and improved pregnancy outcomes, suggesting its potential for managing inflammation-related perinatal complications.

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引用次数: 0

Letter to Humans-written versus ChatGPT-generated case reports 致人类的信-书面与chatgpt生成的病例报告。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-26 DOI: 10.1111/jog.16195

Shunsuke Koga, Wei Du

引用次数: 0

A systematic review and meta-analysis of randomized trials comparing carbetocin to oxytocin in prevention of postpartum hemorrhage after cesarean delivery in low-risk women 一项比较卡贝菌素和催产素预防低危妇女剖宫产后产后出血的随机试验的系统回顾和荟萃分析。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-25 DOI: 10.1111/jog.16194

Ahmed M. Maged, Nour A. El-Goly, Doaa Turki, Nehal Bassiouny, Nihal El-Demiry

<div> <section> <h3> Objectives</h3> <p>To evaluate the efficacy and safety of Carbetocin compared to oxytocin in prevention of postpartum hemorrhage (PPH) after low-risk cesarean delivery (CD).</p> </section> <section> <h3> Search Strategy</h3> <p>Screening of Medline, Web Of Science, Scopus, Google scholar, and clinical trials registry till January 2024 using the key words related to carbetocin, blood loss, PPH, Cesarean section and their MeSH terms was done.</p> </section> <section> <h3> Selection Criteria</h3> <p>This study included all RCTs conducted on women with low risk for developing PPH after CD and compared the administration of carbetocin to oxytocin without any language limitation. These studies compared carbetocin to oxytocin alone or oxytocin combined with misoprostol. The review included all doses and routes of carbetocin and oxytocin administration.</p> </section> <section> <h3> Data Collection and Analysis</h3> <p>The extracted data included study settings, the participants' size and characteristics, intervention details of both the study and control groups especially data about the dose route and timing of drug administration, the outcome parameters and trial registration details The reported outcomes included the requirement of additional uterotonic agents or blood transfusion, the difference between preoperative and postoperative hemoglobin, the occurrence of PPH, blood loss and drug adverse effects.</p> </section> <section> <h3> Main Results</h3> <p>Seventeen studies including 3667 participants were included. The need for additional uterotonic agents was evaluated in 14 studies with 3154 participants and revealed an OR of 0.53 with 95% CI of 0.39 and 0.72 (<i>p</i> < 0.001, <i>I</i><sup>2</sup> 41%). The incidence of PPH was reported in 11 studies with 2228 participants and revealed an Odd ratio of 1.08 with 95%CI of [0.81, 1.44] (<i>p</i> = 0.61, <i>I</i><sup>2</sup> 0%). The hemoglobin drop after the operation was evaluated in 3 studies with 1240 participants and revealed an MD of −0.08 with 95% CI of −0.10 and − 0.06 (<i>p</i> < 0.001, <i>I</i><sup>2</sup> 0%). The need for blood transfusion was evaluated in 9 studies with 1936 participants and revealed an OR of 0.57 with 95% CI of 0.34 and 0.97 (<i>p</i> = 0.04, <i>I</i><sup>2</sup> 0%).</p> </section> <section> <h3> Conclusion</h3> <p>Carbetocin administration during CD in women with low risk for PPH is associated with less need for additional uterotonic agents (moderate evidence), less ne

目的：比较卡贝菌素与催产素预防低危剖宫产（CD）术后产后出血（PPH）的疗效和安全性。检索策略：筛选Medline、Web of Science、Scopus、谷歌scholar、截止2024年1月的临床试验注册表，使用卡霉素、失血、PPH、剖宫产相关关键词及其MeSH术语。选择标准：本研究纳入了所有在CD后发生PPH的低风险妇女中进行的随机对照试验，并比较了卡贝菌素和催产素的使用，没有任何语言限制。这些研究比较了催产素与单独使用催产素或催产素与米索前列醇联合使用。该综述包括卡贝菌素和催产素给药的所有剂量和途径。数据收集和分析：提取的数据包括研究设置、受试者规模和特征、研究组和对照组的干预细节，特别是给药的给药途径和给药时间、结局参数和试验注册细节。报告的结局包括额外使用子宫强张药物或输血的需求、术前和术后血红蛋白的差异、PPH的发生、失血和药物不良反应。主要结果：纳入17项研究，共3667名受试者。在14项3154名参与者的研究中评估了额外子宫扩张药物的需求，结果显示OR为0.53,95% CI为0.39和0.72 （p = 2.41%）。11项研究共报告了2228名参与者的PPH发病率，奇比为1.08,95%CI为[0.81,1.44]（p = 0.61, i2%）。在3项涉及1240名参与者的研究中评估了手术后的血红蛋白下降，结果显示MD为-0.08,95% CI为-0.10和- 0.06 （p < 2%）。9项研究对1936名参与者进行了输血需求评估，结果显示OR为0.57,95% CI为0.34和0.97 （p = 0.04, i2%）。结论：与未增加不良反应的给予催产素的妇女相比，低PPH风险的妇女在CD期间给予卡贝菌素与较少需要额外的子宫扩张药物（中度证据），较少需要输血（高证据）和较低的血红蛋白下降（高证据）相关。

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引用次数: 0

A case of transient hyperthyroidism induced by placental site trophoblastic tumor 胎盘部位滋养细胞瘤致短暂性甲状腺功能亢进1例。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-25 DOI: 10.1111/jog.16193

Sumire Ishii, Takashi Hirayama, Harumi Saeki, Kazunari Fujino, Yasuhisa Terao, Atsuo Itakura

We report a case of placental site trophoblastic tumor (PSTT) with transient hyperthyroidism. A 29-year-old gravida 2 para 2 woman presented with abnormal genital bleeding 6 months after delivery. Endometrial histology suggested PSTT. Serum human chorionic gonadotropin (hCG) was 117 mIU/mL and serum estradiol (E2) were 51 pg/mL. She reported increased appetite, sweating, fatigue, and 7-kg weight loss within 3 months. Blood samples showed a thyroid-stimulating hormone (TSH) level <0.01 μIU/mL, FT3: 24.3 pg/mL, FT4: 5.3 ng/mL. The patient was diagnosed with hyperthyroidism. After thyroid function normalized, laparoscopic hysterectomy and bilateral salpingectomy were performed. Two years postsurgery, there was no recurrence, and thyroid function improved. The hCG produced from gestational trophoblastic disease has stronger TSH activity than that from gestational trophoblasts. However, in PSTT, the E2 level, which increases thyroid-binding proteins and suppresses elevated thyroid hormone levels, is low and may induce hyperthyroidism. In cases of suspected PSTT, thyroid function should be evaluated when hyperthyroid symptoms are present.

我们报告一例胎盘部位滋养细胞瘤（PSTT）合并一过性甲状腺功能亢进。一名29岁妊娠2段妇女在分娩后6个月出现异常生殖器出血。子宫内膜组织学提示PSTT。血清人绒毛膜促性腺激素（hCG） 117 mIU/mL，血清雌二醇（E2） 51 pg/mL。她报告食欲增加、出汗、疲劳，3个月内体重减轻7公斤。血液样本显示有促甲状腺激素（TSH）水平

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引用次数: 0

Anthropometric measurements as predictors of nutritional status in black South African women during pregnancy 人体测量作为南非黑人妇女怀孕期间营养状况的预测指标。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-25 DOI: 10.1111/jog.16184

Christen R. Erasmus, Niren R. Maharaj, Anil A. Chuturgoon

Background

Nutritional risk assessment is an essential component of primary health care screening, especially for pregnant women. The aim of this study was to investigate the relationship between maternal body mass index (BMI) and maternal anthropometric measurements in black South African pregnant women, both with and without human immunodeficiency virus (HIV).

Materials and Methods

A cross-sectional observational study design was used. Two hundred black South African pregnant women were recruited of which 90 were HIV-infected and 110 were HIV-uninfected. The anthropometric measurements assessed included mid-upper arm circumference (MUAC), tricep skinfold (TSF), subscapular skinfold (SSF), mid-arm muscle circumference (MAMC), wrist circumference (WC), frame size, and BMI.

Results

Maternal age was significantly associated with changes in maternal anthropometric measurements. Maternal BMI was significantly correlated with other maternal anthropometric measurements including MUAC, TSF, SSF, MAMC, WC, and frame size. The anthropometric measurements that were found to be accurate for assessing obesity in pregnancy included TSF (≥20.75 mm), SSF (≥21.75 mm), MAMC (≥25.23 cm), and WC (≥16.25 cm). Additionally, SSF (≥15.75 mm) and MAMC (≥23.35 cm) could be used to assess for overweight nutritional status. Lastly, frame size could be used to assess for underweight (≥10.05) and normal (≥9.95) nutritional status. No significant anthropometric differences were observed between the HIV-infected pregnant women and the HIV-uninfected pregnant women in this study.

Conclusion

Surrogate anthropometric measurements offer a simple solution for assessing nutritional status in pregnant women. MUAC was the most accurate method for identifying overweight and obesity. Furthermore, maternal HIV status did not affect the anthropometric measurements.

背景：营养风险评估是初级卫生保健筛查的重要组成部分，特别是对孕妇。本研究的目的是调查南非黑人孕妇，无论有无人类免疫缺陷病毒（HIV），母体体重指数（BMI）和母体人体测量测量之间的关系。材料和方法：采用横断面观察性研究设计。招募了200名南非黑人孕妇，其中90人感染艾滋病毒，110人未感染艾滋病毒。评估的人体测量包括上臂中围（MUAC）、三头肌皮褶（TSF）、肩胛下皮褶（SSF）、上臂中肌围（MAMC）、腕部围（WC）、骨架尺寸和BMI。结果：产妇年龄与产妇人体测量值的变化显著相关。母体BMI与其他母体人体测量指标，包括MUAC、TSF、SSF、MAMC、WC和框架尺寸显著相关。准确评估妊娠期肥胖的人体测量指标包括TSF（≥20.75 mm）、SSF（≥21.75 mm）、MAMC（≥25.23 cm）和WC（≥16.25 cm）。此外，SSF（≥15.75 mm）和MAMC（≥23.35 cm）可用于评估超重营养状况。最后，体格大小可用于评估体重不足（≥10.05）和正常（≥9.95）的营养状况。在本研究中，感染hiv的孕妇和未感染hiv的孕妇之间没有观察到显著的人体测量差异。结论：代孕人体测量为评估孕妇的营养状况提供了一种简单的方法。MUAC是识别超重和肥胖最准确的方法。此外，母体的HIV状况并不影响人体测量值。

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引用次数: 0

Incidence and influencing factors for surgical site infections after cesarean section in China: A systematic review and meta-analysis 中国剖宫产术后手术部位感染的发生率及影响因素：一项系统回顾和荟萃分析。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-23 DOI: 10.1111/jog.16172

Li Guo, Shujuan Huang, Hongmei Sui, Weichao Li

Objective

This study aims to estimate the overall incidence of surgical site infections (SSIs) after cesarean section (CS) and the influencing factors in the Chinese population.

Materials and Methods

The study searched all relevant literature in English and Chinese search databases (English search bases: PubMed, Embase, Cochrane Library, Web of Science; Chinese search bases: China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) up to March 19, 2024, according to the search strategy. A random/fixed effects model was decided on the basis of the I² statistic assessing the magnitude of study heterogeneity, and publication bias was assessed using the Begg's test.

Results

After the selection, a final selection of 25 articles was involved. The estimate of post-CS SSIs in China was 2.4% (95%CI: 0.019, 0.029). Age ≥30 years (WMD: 3.8), pre-pregnancy body mass index (BMI) ≥25 kg/m² (WMD: 1.8), obesity (odds ratio [OR]: 3.0), vaginal cleanliness 3–4 (OR: 4.2), anemia (OR: 1.4), premature rupture of membranes (OR: 2.6), diabetes mellitus (OR: 2.7), National Nosocomial Infections Surveillance System 1–3 (OR: 5.6), emergency surgery (OR: 2.3), trial of labor (OR: 2.9), duration of surgery ≥60 min (OR: 2.0), and intraoperative blood loss >500 mL (OR: 3.5) were the risk factors for post-CS SSIs.

Conclusions

The rate of post-CS SSIs estimated was 2.4% in China. Both maternal conditions and surgical factors can potentially increase the risk of post-CS SSIs.

目的：本研究旨在了解剖宫产术后手术部位感染（ssi）在中国人群中的总体发生率及其影响因素。材料和方法：在中英文检索数据库中检索所有相关文献(英文检索库：PubMed、Embase、Cochrane Library、Web of Science；中国搜索基地：中国国家知识基础设施、万方、中国科技期刊库)，根据搜索策略截止到2024年3月19日。随机/固定效应模型采用I2统计量评估研究异质性的大小，发表偏倚采用Begg检验评估。结果：经过筛选，最终筛选出25篇文章。中国的cs后ssi估计为2.4% （95%CI: 0.019, 0.029）。年龄≥30岁（WMD: 3.8）、孕前体重指数(BMI)≥25kg /m2 （WMD: 1.8）、肥胖（比值比[OR]: 3.0）、阴道清洁度3-4 （OR: 4.2）、贫血（OR: 1.4）、胎膜早破（OR: 2.6）、糖尿病（OR: 2.7）、国家医院感染监测系统1-3 （OR: 5.6）、急诊手术（OR: 2.3）、分娩试验（OR: 2.9）、手术时间≥60分钟（OR: 2.0）、术中出血量500ml （OR: 3.5）是cs后ssi发生的危险因素。结论：中国cs后ssi发生率估计为2.4%。产妇条件和手术因素都可能增加cs后ssi的风险。

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引用次数: 0

A potential inflammatory biomarker for advanced endometrial cancer treated with lenvatinib plus pembrolizumab lenvatinib + pembrolizumab治疗晚期子宫内膜癌的潜在炎症生物标志物。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-23 DOI: 10.1111/jog.16182

Shintaro Yanazume, Yusuke Kobayashi, Yukari Kirita, Ikumi Kitazono, Chikako Nagata, Ayumi Kozai, Akihide Tanimoto, Hiroaki Kobayashi

Introduction

To identify prognostic biomarkers that could predict how well patients will respond to lenvatinib/pembrolizumab (LEN/PEM). The utility of certain inflammatory biomarkers in endometrial liquid-based cytology (LBC) or peripheral blood samples, such as neutrophil counts, lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR) were explored.

Methods

The study included 25 patients with advanced or recurrent endometrial cancer who had received LEN/PEM between August 2018 and March 2024. Predictors for overall response (OR), disease control, and progression-free survival, based on neutrophil/lymphocyte counts, NLR scores of the endometrial LBC prior to initial treatment, and peripheral blood prior to initial treatment and prior to LEM/PEM treatment were compared using a receiver operating characteristic curve. Significant predictors were evaluated using the log-rank test, and multivariate analysis.

Results

Although neutrophil counts and NLR score in endometrial LBC prior to initial treatment were better effective predictors for OR, the most accurate predictor of a progression-free status was NLR score in peripheral blood prior to LEM/PEM (0.722, 95% CI: 0.45–0.99, sensitivity: 57.1%, specificity: 94.4%). In peripheral blood prior to LEN/PEM, the lower NLR (NLR <5.39) group had a significantly longer PFS than the higher NLR (5.39 ≤ NLR) group (p = 0.023, median survival: 13.5 vs. 3.0 months), and tended to be independently correlated with PFS (hazard ratio = 2.571; 95% CI = 0.857–7.719; p = 0.092).

Conclusion

Inflammatory biomarkers in endometrial LBC failed to predict the efficacy of LEN/PEM, while peripheral blood NLR score sampled prior to LEN/PEM potentially could be a significant predictor.

目的：确定预后生物标志物，以预测患者对lenvatinib/pembrolizumab （LEN/PEM）的反应。探讨了某些炎症生物标志物在子宫内膜液基细胞学（LBC）或外周血样本中的应用，如中性粒细胞计数、淋巴细胞计数和中性粒细胞与淋巴细胞比率（NLR）。方法：该研究纳入了2018年8月至2024年3月期间接受LEN/PEM治疗的25例晚期或复发子宫内膜癌患者。根据中性粒细胞/淋巴细胞计数、初始治疗前子宫内膜LBC NLR评分、初始治疗前和LEM/PEM治疗前的外周血，使用接受者工作特征曲线比较总体缓解（OR）、疾病控制和无进展生存期的预测指标。使用log-rank检验和多变量分析评估显著预测因子。结果：虽然初始治疗前子宫内膜LBC的中性粒细胞计数和NLR评分是更有效的OR预测指标，但最准确的无进展状态预测指标是LEM/PEM前外周血NLR评分（0.722,95% CI: 0.45-0.99，敏感性：57.1%，特异性：94.4%）。结论：子宫内膜LBC中的炎症生物标志物无法预测LEN/PEM的疗效，而LEN/PEM之前采集的外周血NLR评分可能是一个重要的预测因子。

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