Correlations of serum transforming growth factor-β1 and insulin-like growth factor-1 with pathological features and postoperative recurrence in patients with adenomyosis

Objective To investigate the correlations of expression levels of serum transforming growth factor-β1 (TGF-β1) and insulin-like growth factor-1 (IGF-1) with clinicopathological features of patients with adenomyosis, and the clinical value of their prediction of postoperative recurrence.

Methods Eighty-two patients with adenomyosis were selected as study subjects (study group). Patients were followed up for two years after surgery and divided into recurrence group (n=15) and non-recurrence group (n=67) based on their postoperative status. An additional 85 healthy individuals who underwent physical examinations during the same period were selected as control group. Serum TGF-β1 and IGF-1 levels were compared between the study group and the control group. The correlations of serum TGF-β1 and IGF-1 levels with the clinicopathological characteristics of adenomyosis patients was analyzed. Serum TGF-β1 and IGF-1 levels were compared between the recurrence and non-recurrence groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of serum TGF-β1 and IGF-1 levels in predicting postoperative recurrence in adenomyosis patients.

Results Serum TGF-β1 and IGF-1 levels in the study group were significantly higher than those in the control group (P < 0.05). Serum TGF-β1 levels were correlated with menstrual volume, history of curettage, uterine volume, pathological type, lesion volume, endometrial status and ectopic gland cycle (P < 0.05). Serum IGF-1 levels were correlated with menstrual volume, history of curettage, uterine volume, pathological type, endometrial status and ectopic gland cycle (P < 0.05). Postoperative serum TGF-β1 and IGF-1 levels in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for predicting postoperative recurrence using serum TGF-β1, IGF-1 and their combination were 0.823, 0.803 and 0.940, respectively. The clinical efficacy of TGF-β1 and IGF-1 in combination in predicting postoperative recurrence was superior to that of TGF-β1 alone (Z_{combined with TGF-β1}=2.001, Z_{combined with IGF-1}=2.318, P=0.045, 0.021).

Conclusion The serum levels of TGF-β1 and IGF-1 in patients with adenomyosis are significantly increased, which are closely related to the clinicopathological features of the patients. The combination of serum TGF-β1 and IGF-1 levels has high clinical efficacy in predicting postoperative recurrence.