Objective To analyze the changes in serum levels of microRNA-26a (miR-26a) and microRNA-34a (miR-34a) before and after single-port laparoscopic surgery for uterine fibroids (UF), as well as the value of their combined use in predicting postoperative recurrence.

Methods A total of 200 UF patients who underwent single-port laparoscopic surgery were selected as study group, and 100 healthy women who underwent physical examinations during the same period were selected as control group. The serum levels of miR-26a and miR-34a were compared between the two groups. All patients in the study group were followed up for 1 year after surgery, and the postoperative recurrence status was recorded. The general information, as well as the preoperative and postoperative (at the 3rd month) serum miR-26a and miR-34a levels and their changes (denoted by △, representing the absolute difference value between preoperative and the 3rd postoperative month) were compared between recurrent and non-recurrent patients, and the influencing factors for postoperative recurrence were screened. The value of △miR-26a and △miR-34a in predicting postoperative recurrence in UF patients was analyzed.

Results The preoperative serum miR-26a and miR-34a levels in the study group were significantly lower than those in the control group (P < 0.05). In the study group, 5 were lost to follow-up during the postoperative follow-up period, ultimately, 195 patients completed the follow-up, of whom 51 patients experienced recurrence, with a recurrence rate of 26.15% (51/195). The number of UF in recurrent patients was significantly higher, the maximum diameter of UF was significantly larger, and the serum carbohydrate antigen-199 (CA-199) and carcinoembryonic antigen (CEA) levels at 24 hours postoperatively were significantly higher in recurrent patients than those in non-recurrent patients (P < 0.05). At the 3rd month postoperatively, the serum miR-26a and miR-34a levels in both recurrent and non-recurrent patients in the study group were significantly higher than those preoperatively (P < 0.05). The preoperative and postoperative (at the 3rd month) serum miR-26a and miR-34a levels, as well as △miR-26a and △miR-34a were significantly lower in recurrent patients than those in non-recurrent patients (P < 0.05). The number of UF, serum CA-199 and CEA levels at 24 hours postoperatively, △miR-26a and △miR-34a were all influencing factors for postoperative recurrence in UF patients (P < 0.05). The area under the curve (AUC) for predicting postoperative recurrence using the combination of △miR-26a and △miR-34a was 0.847, which was greater than the AUCs for predicting recurrence using △miR-26a, △miR-34a, the number of UFs as well as serum CA-199 and CEA levels at 24 hours postoperatively alone (P < 0.05).

Conclusion The serum miR-26a and miR-34a levels are significantly decreased in UF patients, and their changes before and after surgery are closely related to postoperative recurrence. The combined predictive efficacy of △miR-26a and △miR-34a for postoperative recurrence is significantly superior to that of traditional tumor markers.