Due to the small number of cases at time point T2, variables were entered into the model for the recurrence of myomas at p < 0.15. Various models of the influence of the biomarkers on the presence or recurrence of myomas at different time points were tested by means of logistic regression. Spearman’s correlation coefficient was used to test the correlation between the levels of the blood values of LDH, CA 125, and IGF-1 and the various parameters of the myomas, such as size, weight, number, and location, as well as the intensity of symptoms. For each of the 3 potential biomarkers, the Wilcoxon test for paired samples was used to compare the values at T0 versus T1 and at T1 versus T2. The results of the biomarkers and other continuous variables were summarized as the median and interquartile range. Since there was no normal distribution, the further evaluation was done with nonparametric tests. The normal distribution of the data was checked with the Kolmogorov-Smirnov test. A p value <0.05 was considered significant. Released 2015, IBM SPSS Statistics for Windows, Version 23.0 IBM Corp., Armonk, NY, USA) was used for the statistical evaluation of the data. (1) Do the values of the biomarkers correlate primarily with the size or the location of the myomas or the severity of symptoms? (2) Does a drop in a single or multiple biomarkers occur immediately postoperatively after myoma removal? (3) Does the recurrence of myomas 6 months postoperatively, which can be demonstrated by means of ultrasound, correlate with a resurgence of individual biomarkers? (4) Can a cutoff value be defined, and if so which biomarker or biomarkers should be viewed as predictive values for the recurrence of myomas? Or can individual or multiple values of the biomarkers in combination with other parameters provide information on the occurrence of myomas? (5) Are the serum values of LDH higher when sonographic or histopathological signs of degeneration/necrosis of myomas are present? Materials and Methods The following 4 secondary study questions were also answered. The aim of this prospective study was to investigate whether the surgical removal of myomas leads to a decrease of the potential myoma biomarkers of LDH, CA 125, and IGF-1. This study concludes that myomas do influence LDH and IGF-1 and could possibly be suitable as biomarkers. Future studies should be able to confirm these results. The postoperative concentration of IGF-1 was correlated with the evidence of new myomas and can be potentially used for further monitoring. Conclusion: Both LDH and IGF-1 dropped significantly in the immediate postoperative days in women with myomas after uterus-preserving surgeries were performed. In contrast, the median (Q1–Q3) IGF-1 level at T2 was significantly elevated both in patients with sonographic evidence of new myomas (129.0 ng/mL, p = 0.023) and in patients with sonographic proof of no new myomas (161.0 ng/mL, p < 0.001). This was observed both in patients with and without a recurrence of myoma. At 6 months ( n = 34), the LDH values were not significantly different from either the preoperative or the immediate postoperative values. By contrast, the CA 125 values rose slightly but not significantly. Results: The median (Q1–Q3) LDH values dropped significantly postoperatively: 239 (217–266) U/L at T0 versus 217 (190–255) U/L at T1, p < 0.001. Vaginal sonography was performed preoperatively and once again at 6 months postoperatively. Study Design: The blood levels of LDH, CA 125, and IGF-1 were determined in 83 patients (age 18–50) with a verified diagnosis of myomas and surgical therapy at 3 different timepoints: preoperative (T0), 2 days postoperative (T1), and 6 months postoperative (T2). The primary aim of this study was to determine if the surgical removal of myomas leads to a drop of lactate dehydrogenase (LDH), CA 125, and/or insulin-like growth factor (IGF-1) and therefore if these parameters are suitable as potential biomarkers for the presence or recurrence of a myoma. At present, sonography and clinical examination are the prevalent diagnostic standards for these tumors, and no biomarkers have been established yet. Objective: Myomas are one of the most common tumors of the lower abdomen in women.
0 Comments
Leave a Reply. |