Abstract | OBJECTIVES: We aimed to explore the epidemiological characteristics of suspected adenomyosis within a physical examination population in China. DESIGN: A retrospective, nested case-control study; we matched healthy people and those with potential adenomyosis on a 1:2 ratio by age. SETTING: A tertiary hospital health management centre. PARTICIPANTS: We included 15-60 years old women who underwent at least one uterine examination from October 2017 to December 2020, excluding those who had undergone hysterectomy and menopause. PRIMARY AND SECONDARY OUTCOME MEASURES: We estimated the incidence and prevalence rate of suspected adenomyosis. Conditional logistic regression was used to estimate associations between serum biomarkers and potential adenomyosis. Areas under the receiver-operating characteristic curves (AUC) were used to determine the cut-off point of the cancer antigen 125 (CA125) level for suspected adenomyosis. RESULTS: A total of 30 629 women had uterus-related imaging examinations; 877 had suspected adenomyosis. The standardised incidence and prevalence of suspected adenomyosis was 1.32% and 2.35%, respectively, for all age groups. The conditional logistic regression analysis results showed that total bilirubin≥18.81 µmol/L (HR: 2.129; 95% CI 1.067 to 4.249; p<0.0321) and CA125 levels (HR: 1.014; 95% CI 1.002 to 4.731; p<0.0273) were positively correlated with onset of suspected adenomyosis; body mass index>24 kg/m2 (HR: 1.262; 95% CI 1.055 to 1.511; p<0.0109), CA125 levels (HR: 1.007; 95% CI 1.006 to 1.009; p<0.0001), and blood platelet levels (HR: 1.002; 95% CI 1 to 1.003; p<0.0141) were positively correlated with potential adenomyosis. The optimal cut-off of CA125 for new suspected adenomyosis was 10.714 U/mL, with a sensitivity of 77.42%, specificity of 53.76%, and AUC of 0.7841 (95% CI 0.7276 to 0.8407). CONCLUSIONS: The disease burden of suspected adenomyosis remains huge and can be informed by biomarkers. The disease-specific threshold of CA125 will support further preventive strategy development in population. TRIAL REGISTRATION NUMBER: ChiCTR2100049520, 2021/8/2.
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Authors | Yanyan Huang, Xueyao Su, Ke Chen, Lijun Zhang, Wei Xu, Yang Pu, Fan Xu, Ruoyan Gong, Jiayuan Zhang, Yuxian Nie, Qiuling Shi |
Journal | BMJ open
(BMJ Open)
Vol. 14
Issue 1
Pg. e074488
(01 12 2024)
ISSN: 2044-6055 [Electronic] England |
PMID | 38216177
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
Chemical References |
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Topics |
- Female
- Humans
- Adolescent
- Young Adult
- Adult
- Middle Aged
- Adenomyosis
(diagnosis, epidemiology, complications)
- Case-Control Studies
- Retrospective Studies
- Hysterectomy
- CA-125 Antigen
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