Prediction of adenomyosis in patients with uterine fibroids

Abstract

Aim. To determine the clinical, anamnestic, and immunological predictors of adenomyosis by developing a prognostic model of uterine fibroids with concomitant adenomyosis. Materials and methods. A retrospective single-center study was conducted at Kurbatov Novokuznetsk City Clinical Hospital №1, from 2012 to 2019. The model included 284 women with histologically confirmed uterine fibroids, of which 34.9% (99/284) were fibroids with adenomyosis and 65.1% (185/284) were isolated uterine fibroids. Logistic regression was used to develop the mathematical model. Results. Predictors of adenomyosis in patients with uterine fibroids have been established: age 43 years and older, concomitant endometrial hyperplasia, chronic inflammatory diseases of the cervix, menometrorrhagia, history of childbirth, history of endometrial disorders, varicose veins of the lower extremities, history of appendectomy, blood serum lactoferrin of more than 1.8 mg/L, interleukin-6 levels more than 2.8 pg/mL. The model has an accuracy of 91%, a sensitivity of 90%, a specificity of 92%, a positive predictive value of 85%, and a negative predictive value of 94%. Conclusion. The established predictors of adenomyosis allow for predicting the risk of adenomyosis in patients with uterine fibroids, facilitating effective treatment choices.