Systemic Immune-Inflammation Indices Could Be Additional Predictive Markers for Cesarean Scar Pregnancy

IF 2.5 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2024-09-02 DOI:10.1111/aji.13924

Jing Gao, Nanyan Jiang, Qi Chen, Min Zhao, Yunhui Tang

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Abstract

Problem

Cesarean scar pregnancy (CSP) is characterized by a gestational sac fully or partially implanted in the scar from a previous cesarean section. Systemic immune-inflammation indices (SIIs) have recently been discussed as additional diagnostic markers in placenta accreta and preeclampsia. CSP shares a similar pathogenesis with these diseases, suggesting that assessing the SIIs and neutrophil-to-lymphocyte ratio (NLR) could enhance additional predictability in diagnosing CSP.

Method of Study

In this study, we analyzed the complete blood counts between 264 women who were confirmed with CSP by ultrasound and 295 women who underwent elective termination.

Results

The mean counts of total white cells and neutrophils were significantly higher, whereas the counts of monocytes, lymphocytes, and platelets were significantly lower in the CSP group compared to the control group (p < 0.001). Additionally, the SII, systemic inflammation response index (SIRI), or NLR was significantly higher in the CSP group compared to the control group (p < 0.0001). Given the limited effect of SII and SIRI on the increased risk of developing CSP, the optimal cut-off value for NLR in predicting CSP was 2.87 (area under the curve [AUC] 0.656, 68% sensitivity). The optimal cut-off value for NLR in predicting type 2 CSP was 2.91 (AUC 0.690, 71% sensitivity).

Conclusions

Although ultrasound or magnetic resonance imaging images are a gold standard for visualizing the gestational sac's location in the diagnosis of CSP, assessing peripheral blood tests is cost-effective, and NLR may provide additional diagnosis value for CSP.

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全身免疫炎症指标可作为剖腹产瘢痕妊娠的额外预测指标

问题：剖宫产瘢痕妊娠（CSP）的特点是妊娠囊全部或部分植入前次剖宫产手术留下的瘢痕中。系统免疫炎症指数（SIIs）最近被认为是胎盘早剥和子痫前期的额外诊断指标。CSP 与这些疾病的发病机制相似，这表明评估 SIIs 和中性粒细胞与淋巴细胞比值（NLR）可提高诊断 CSP 的预测能力：在这项研究中，我们分析了 264 名通过超声波确诊为 CSP 的妇女和 295 名接受选择性终止妊娠的妇女的全血细胞计数：结果：与对照组相比，CSP 组的白细胞总数和中性粒细胞的平均计数明显较高，而单核细胞、淋巴细胞和血小板的计数则明显较低（P 结论：虽然超声或核磁共振成像结果显示，CSP 组的白细胞总数和中性粒细胞的平均计数明显较高，而单核细胞、淋巴细胞和血小板的计数则明显较低（P）：虽然超声波或磁共振成像图像是诊断 CSP 时观察孕囊位置的金标准，但评估外周血化验具有成本效益，NLR 可为 CSP 提供额外的诊断价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.