Abstract: Objective To explore the relationship between the prognosis and vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), tissue plasminogen activator (tPA) in patients with endometriosis (EM). Methods Eighty-four EM patients, who were treated with conservative surgery, were selected as the study objects. According to the follow-up of 1 year after surgery, they were divided into recurrence group (11 cases) and non recurrence group (73 cases). The levels of VEGF, MMP-9 and tPA were measured before and after operation, and ROC curve was used to analyze the prognostic value of VEGF, MMP-9 and tPA in EM patients. Results Before surgery, there was no significant difference in the levels of VEGF, MMP-9, and tPA between the two groups of patients (P>0.05). On the 7th day after operation, the levels of VEGF and MMP-9 of the two groups were lower than that of preoperatively, while the levels of tPA were higher than that of preoperative, the differences were statistically significant (P<0.05). The levels of VEGF and MMP-9 were lower than that of patients in the recurrence group, and the tPA level was higher than that of patients in the recurrence group, the difference were statistically significant (P<0.05). ROC curve analysis showed that the AUC of serum VEGF, MMP-9, and tPA levels in evaluating the prognosis of EM patients were 0.783, 0.766, and 0.788, respectively, which had certain accuracy, and the evaluation value of the three-item combination (AUC=0.808, P<0.01) was higher. Conclusion The levels of VEGF, MMP-9, and tPA in patients with endometriosis are closely related to the prognosis, and the three combined tests are more valuable for their prognostic evaluation.

Key words: endometriosis, vascular endothelial growth factor, matrix metalloproteinase-9, tissue plasminogen activator, prognosis

摘要： 目的 探讨子宫内膜异位症（EM）患者血管内皮生长因子（VEGF）、基质金属蛋白酶-9（MMP-9）、组织型纤溶酶原激活物（tPA）与预后的关系。方法 选择84例行保守手术治疗的EM患者为研究对象,根据术后1年的预后随访情况,分为复发组（11例）及未复发组（73例）。抽血检测两组患者手术前后的VEGF、MMP-9、tPA水平,并使用ROC曲线分析VEGF、MMP-9、tPA水平对EM患者预后的评估价值。结果 术前,两组患者的VEGF、MMP-9、tPA水平比较,差异无统计学意义（P>0.05）。术后7d,两组患者的VEGF、MMP-9水平均低于术前,而tPA水平均高于术前,差异具有统计学意义（P<0.05）,且未复发组患者的VEGF、MMP-9水平均低于复发组患者.,而tPA水平高于复发组患者,差异具有统计学意义（P<0.05）。ROC曲线分析显示,血清VEGF、MMP-9、tPA水平评估EM患者预后的AUC分别为0.783、0.766、0.788,具有一定准确性,且三项联合（AUC=0.808,P<0.01）检测的评估价值更高。结论 子宫内膜异位症患者的VEGF、MMP-9、tPA水平与预后密切相关,三项联合检测对其预后评估的价值更高。

关键词: 子宫内膜异位症, 血管内皮生长因子, 基质金属蛋白酶-9, 组织型纤溶酶原激活物, 预后