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Abstract
Objective To analyze the expression levels of nerve growth factor (NGF) and transforming growth factor-β1 (TGF-β1) in patients after laparoscopic myomectomy and their relationship with postoperative recurrence. Methods A prospective cohort study was conducted, a total of 212 patients with uterine fibroids who underwent laparoscopic myomectomy in the Second People's Hospital of Hengshui from January to November 2023 were enrolled, and were followed up for 12 months after surgery. According to the postoperative recurrence of patients, the patients were divided into recurrence group (n=43) and non-recurrence group (n=169). The clinical data of the two groups were compared; the serum expression levels of NGF and TGF-β1 in the two groups before and 1 month after surgery were detected; receiver operating characteristic (ROC) curve was drawn to analyze the predictive efficacy of serum NGF and TGF-β1 expression levels on postoperative recurrence, Spearman rank correlation analysis was used to investigate the correlations between serum NGF, TGF-β1 expression levels and the number and maximum diameter of fibroids; multivariate Logistic regression analysis was used to screen the factors affecting the postoperative recurrence of patients after laparoscopic myomectomy. Statistical analysis was performed using the independent sample t-test and χ2 test. Results Compared with the non-recurrence group, the proportions of patients with the number of fibroids >2 and maximum diameter of fibroids >5 cm in the recurrence group were significantly higher (all P<0.05). There were no significant differences in age, body mass index, family history of uterine fibroids, age of menarche, location of fibroids and postoperative pregnancy between the two groups (all P>0.05). There were no significant differences in serum NGF and TGF-β1 levels between the two groups before surgery (all P>0.05), and the expression levels of NGF and TGF-β1 in the two groups after surgery were significantly lower than those before surgery (all P<0.05), and the levels in the non-recurrence group were lower than those in the recurrence group (all P<0.05).
ROC curve analysis showed that the area under the curve (AUC) of postoperative recurrence predicted
by serum NGF and TGF-β1 expression levels was 0.869 and 0.865, the sensitivity was 86.05% and
81.40%, and the specificity was 86.39% and 87.57%, respectively. The AUC predicted by both methods
was 0.951, which was higher than NGF (Z=2.958, P=0.003) and TGF-β1 (Z=2.896, P=0.004) alone,
and the sensitivity and specificity were 76.74% and 97.63%, respectively. Spearman rank correlation
analysis showed that serum NGF and TGF-β1 expression levels were positively correlated with the number of fibroids (r values were 0.421, 0.368, all P<0.001), while they were not significantly correlated with the maximum diameter of fibroids (r values were 0.126, 0.203, all P>0.05). Multivariate Logistic regression analysis showed that the number of fibroids >2, the maximum diameter of fibroids >5cm, and the increase of serum NGF and TGF-β1 were all independent risk factors for postoperative recurrence in patients (all P<0.05). Conclusion The expression levels of serum NGF and TGF-β1 in patients after laparoscopic myomectomy significantly decreased. Both of these factors have certain value in predicting postoperative recurrence of the patients, and the combination of the two factors has even greater predictive value.
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2026, Vol. 14 
