Risk Factors for Recurrence and Their Predictive Value in Endometriosis Patients After Laparoscopic Surgery

Objective To identify the factors influencing postoperative recurrence in endometriosis patients after laparoscopic surgery and to evaluate their clinical predictive performance for postoperative recurrence.

Methods The clinical data of 190 endometriosis patients who underwent laparoscopic surgery at our hospital between January 2019 and January 2024 were retrospectively collected. Patients were divided into a non-recurrence group (109 cases) and a recurrence group (81 cases) based on their status of postoperative recurrence. Univariate analysis was performed with the clinical data. Multivariate logistic regression analysis was performed to identify the influencing factors of recurrence after laparoscopic surgery. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of the relevant indicators.

Results According to the results of the univariate analysis, the prevalence of preoperative history of dysmenorrhea, number of preoperative pregnancies, history of previous uterine cavity procedures, smoking, and drinking in the non-recurrence group was lower than that in the recurrence group (P < 0.05). The non-recurrence group also had lower preoperative serum levels of transforming growth factor-β1 (TGF-β1), interleukin (IL)-1β, IL-17, and IL-22 compared with those of the recurrence group (P < 0.05). Except for the history of previous uterine cavity procedures, drinking, and the level of IL-17, all other factors were independent risk factors for recurrence after laparoscopic surgery (P < 0.05). The area under the curve (AUC) for preoperative serum TGF-β1 + IL-1β and TGF-β1 + IL-1β + IL-22 was 0.980 (95% CI, 0.965-0.994) and 0.982 (95% CI, 0.968-0.996), respectively, indicating a high predictive value for recurrence in patients after laparoscopic surgery.

Conclusion The history of preoperative dysmenorrhea, number of preoperative pregnancies, smoking, and preoperative levels of serum TGF-β1, IL-1β, and IL-22 are risk factors for the recurrence of endometriosis after laparoscopic surgery. The combination of TGF-β1 and IL-1β, as well as the combination of TGF-β1, IL-1β, and IL-22, both demonstrated good performance for predicting the recurrence of endometriosis after laparoscopic surgery.