子宫内膜异位症不孕患者腹腔液中可溶性细胞间黏附分子-1检测的临床意义

Expression of soluble intracellular adhesion molecule in peritoneal fluid on patients of sterility with endometriosis

目的 探讨腹腔液中可溶性细胞间黏附分子 ( s ICAM- 1)在子宫内膜异位症 (简称内异症 )检测中的意义。 方法 收集 80例因不孕行腹腔镜诊治术患者的腹腔液及其术前空腹抽血各3m l,均用酶联免疫吸附双抗体夹心 ( EL ISA)法测腹腔液中 s ICAM- 1及血清中 CA1 2 5水平。其中 4 0例镜下确诊为内异症患者 ,作为研究组 ;另 4 0例镜下确诊为正常盆腔 ,作为对照组。 结果 内异症患者腹腔液中 s ICAM- 1和 CA1 2 5水平分别为 ( 5 4 .0± 2 1.1)× 10 - 1 2 m ol/ L和 ( 30 .7± 18.6 ) U / ml明显高于对照组 ( 36 .2± 19.2 )× 10 - 1 2 m ol/ L 和 ( 18.4± 17.2 ) U/ m l( P<0 .0 1) ,内异症组内重度组 ( 6 1.3± 2 1.5 )× 10 - 1 2 mol/ L 和 ( 40 .2± 2 0 .2 ) U/ m l高于轻度组 ( 45 .7± 18.3)× 10 - 1 2 m ol/ L 和( 2 6 .2± 14 .7) U/ ml ( P<0 .0 5 ) ,s ICAM- 1与 CA1 2 5联合检测的敏感性 72 .5 %较 s ICAM- 1或 CA1 2 5单项检测的敏感性 5 0 .0 %或 4 5 .0 %明显提高 ,差异有显著性 ( P<0 .0 5 )。 结论 内异症患者腹腔液中 s ICAM- 1可以作为内异症的检测指标 ,其与 CA1 2

Objective To study the relationship between intracellular adhesion molecule-1(ICAM-1) and endometriosis. Methods The expression of sICAM-1 in peritoneal fluid(PF) and CA 125 in serum were determined by enzyme-linked immunosorbent assays(ELISA) on 40 patients with endometriosis and 40 from non-endometriosis normal control subjects during the same menstrual phase,and then analysed by F test and T test. Results The expression of sICAM-1 in PF from patients with endometriosis was significantly higher than those in controls,and the advanced group was higher than the early group.The same case was seen in CA 125 in serum.The sensitivity and specificity of sICAM-1 in detecting peritoneal endometriosis were 0.5 and 0.8,respectively;whereas those of CA 125 were 0.5 and 0.9,respectively.When both parameters were used concomitantly,the sensitivity and specificity were 0.7 and 0.8,respectively. Conclusion PF concentrations of sICAM-1 seem to be an effective indicator for the diagnosis of endometriosis.However,an integrated approach using both sICAM-1 and CA 125 may be helpful in specifically identifying woman with peritomeal endometriosis.