BACKGROUND Endometriosis is defined as a chronic inflammatory disease. Recent studies have shown that increased coagulation parameters including fibrinogen and platelets are associated with endometriosis. The objective of this study was to determine the levels of inflammatory markers and coagulation parameters and their correlations in women with endometriomas compared to those with benign ovarian cysts or normal pelvic anatomy. METHODS Between June 2015 and June 2017, a total of 548 women who underwent laparoscopic/laparotomic surgery for ovarian endometriomas (OMA group, n = 226), non-endometriosis benign ovarian cysts (Cyst group, n = 210) and tubal reanastomosis (Control group, n = 112) were recruited in this study. Inflammatory markers including c-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and coagulation parameters including platelet count, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time, and plasma fibrinogen as well as CA-125 were determined. RESULTS Compared with Cyst group and Control group, TT and PT in OMA group were significantly shorter and plasma fibrinogen levels were significantly higher (P < 0.05). Moreover, the levels of plasma fibrinogen were positively correlated with CRP, NLR and PLR (P < 0.05). In addition, the confidence intervals for the area under the curve (AUC) for CA-125 × fibrinogen were significantly higher than those for CA-125 (0.904-0.952 vs. 0.899-0.949) in the diagnosis of endometrioma. CONCLUSIONS These results indicate that women with endometriomas demonstrate a hypercoagulable status due to the inflammatory nature of endometriosis. The combined determination for CA-125 and fibrinogen demonstrate a higher area under the curve than the single detection of CA-125 in those with endometriomas compared to these with benign ovarian cysts. TRIAL REGISTRATION This study was approved by the Human Ethics Committee of the Women's Hospital, School of Medicine, Zhejiang University (No.20170174) and all women provided written informed consent.

中文翻译：

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晚期卵巢子宫内膜异位症患者的炎症标志物与凝血参数之间是否存在相关性？

背景技术子宫内膜异位症定义为慢性炎性疾病。最近的研究表明，包括纤维蛋白原和血小板在内的凝血参数增加与子宫内膜异位症有关。这项研究的目的是确定子宫内膜瘤与良性卵巢囊肿或骨盆解剖正常的女性相比，炎症标志物和凝血参数的水平及其相关性。方法在2015年6月至2017年6月期间，共有548例接受了腹腔镜/腹腔镜手术治疗卵巢子宫内膜异位症（OMA组，n = 226），非子宫内膜异位良性卵巢囊肿（Cyst组，n = 210）和输卵管再吻合术（对照）的女性组，n = 112）在这项研究中被招募。炎症标志物包括c反应蛋白（CRP），中性粒细胞与淋巴细胞之比（NLR），确定血小板与淋巴细胞的比例（PLR）和凝血参数，包括血小板计数，凝血酶时间（TT），凝血酶原时间（PT），活化的部分凝血活酶时间，血浆纤维蛋白原以及CA-125。结果与囊肿组和对照组相比，OMA组TT和PT明显缩短，血浆纤维蛋白原水平明显升高（P <0.05）。此外，血浆纤维蛋白原水平与CRP，NLR和PLR呈正相关（P <0.05）。此外，在诊断子宫内膜异位症时，CA-125×纤维蛋白原的曲线下面积（AUC）的置信区间显着高于CA-125的置信区间（0.904-0.952对0.899-0.949）。结论这些结果表明，由于子宫内膜异位症的炎症性质，子宫内膜异位症妇女表现出高凝状态。子宫内膜瘤患者与卵巢良性囊肿患者相比，CA-125和纤维蛋白原的联合测定结果显示曲线下面积比CA-125的单次检测高。试验注册本研究得到浙江大学医学院附属妇女医院人类伦理委员会的批准（No.20170174），所有妇女均提供了知情同意书。