Identification of diagnostic blood indicators associated with adenomyosis: a retrospective cohort study

Background: Adenomyosis (AM) is described as a benign invasion of the endometrium into the myometrium, which impacts a large number of childbearing age women. The diagnosis of AM relies on imaging and histological examinations. Although carbohydrate antigen 125 (CA125) has served as a blood indicator for AM diagnosis, its utility is limited to being effective in only approximately half of patients. Currently, there are no reliable blood diagnostic indicators available for AM. Methods: controls. Similarly, Wilcoxon rank-sum test was conducted to determine the DCIs associated with the MRI subtypes of AM. Univariate and multivariate analyses were performed to select the DCIs that might differentiate severe from mild AM. Least absolute shrinkage and selection operator (LASSO) and support vector machine recursive feature elimination (SVMRFE) were used to determine the key DCIs for AM. Logistic regression was carried out to develop a diagnostic model, and the area under the receiver operating characteristic (ROC) curve (AUC) was calculated to evaluate the performance of the model. A nomogram was constructed to predict the risk of AM. Results: We identified 15 DCIs for AM. Four DCIs were found in all three MRI subtypes. CA125 and estradiol could distinguish severe from mild AM. The hemoglobin (HGB) concentration, lymphocyte percentage, neutrophil count, neutrophil percentage, and testosterone were different between diffuse AM and adenomyoma. Based on these DCIs, neutrophil count, HGB concentration, and high-density lipoprotein (HDL) were selected using the LASSO and SVMRFE methods, which could discriminate AM cases with CA125