血清炎性生物标记物在子宫内膜异位症患者血清中的表达及意义

Expression and significance of inflammatory biological markers in serum of patients with endometriosis

目的探讨炎性因子TNF-α、IL-1β、IL-6、IL-8及CA-125、MMP-3、VEGF在子宫内膜异位症患者血清中表达变化及其意义,分析其与患者EMs病变r-AFS临床分期及EMs患者痛经程度的相关性。方法采用酶联免疫法(ELISA)检测入组患者血清中TNF-α、IL-1β、IL-6、IL-8,CA-125、MMP-3、VEGF的浓度。分析EMs患者血清中TNF-α、IL-1β、IL-6、IL-8、CA-125、MMP-3、VEGF的浓度与正常对照人群的差异;分析不同分期EMs患者血清中上述标记物的浓度差异;分析EMs患者术前术后血清中上述标记物的表达变化情况;分析EMs患者血清中上述标记物与痛经评分的相关性。结果炎性相关因子TNF-α、IL-1β、IL-6、IL-8及CA-125、VEGF浓度在EMs患者血清中显著升高(P<0.05),并且随着EMs病变γ-AFS临床分期加重而增加,手术切除病灶后血清中上述指标浓度迅速回落;此外严重痛经EMs患者血清中TNF-α、IL-1β及IL-6的浓度较无痛经EMs患者高(P<0.05)。EMs患者血清中TNF-α、IL-1β及IL-6浓度与患者痛经严重程度呈正相关(P<0.05)。MMP-3在EMs患者血清中浓度显著升高(P<0.05),手术切除病灶后血清中MMP-3迅速下降,然而血清中MMP-3浓度与EMs患者r-AFS临床分期无显著性关联,血清中MMP-3浓度与EMs患者痛经严重程度亦无明显相关性(P<0.05)。结论测定EMs患者血清中TNF-α、IL-1β、IL-6、IL-8及CA-125、MMP-3、VEGF浓度对于EMs的临床诊断具有一定价值,并且可作为无创性辅助检查手段。

Objective To investigate the the changes and significance of serum levels of inflammatory cytokines including TNF-α,IL-1β,IL-6,IL-8,CA-125,MMP-3,and VEGF in serum of patients with endometriosis（ EMs）,and to analyze the correlation between the changes and pathological changes of EMs,γ-AFS clinical staging and dysmenorrhea degree of patients. Methods A total of 61 patients with endometriosis（ observation group） and 36 healthy women（ control group）were enrolled in the study. The serum levels of TNF-α,IL-1β,IL-6,IL-8,CA-125,MMP-3,and VEGF in both groups were detected by immunosorbent assay（ ELISA）,and the differences between the two groups were analyzed. Moreover the differences of the serum levels of these factors in patients with EMs at different stages were observed before operation and after operation. The correlation between these factors and dysmenorrhea scores of patients were analyzed. Results The serum levels of TNF-α,IL-1β,IL-6,IL-8,CA-125 and VEGF in observation group were significantly higher than those in control group（ P〈 0. 05）,moreover,which were increased with the aggravation of pathological changes of Ems and γ-AFS clinical staging,however,which were decreased rapidly after resection of ectopic endometrium. Moreover the serum levels of TNF-α,IL-1βand IL-6 of patients with severe dysmenorrhea were significantly higher than those of patients without dysmenorrhea（ P〈 0. 05）.The serm levels of TNF-a,IL-1βand IL-6 in patients with EMs were positively correlated to the severity of dysmenorrhea of patients. The serum levels of MMP-3 in serum of patients with EMs were significantly increased（ P〈 0. 05）. After resection of ectopic endometrium the serum levels of MMP-3 were decreased quickly,however,the serum levels of MMP-3 were not closely correlated to r-AFS clinical staging of patients with EMs,moreover,which were not closely related with the severity of dysmenorrhea of patients. Conclusion The detection of serum levels of TNF-α,IL-1β,IL-6,IL-8,CA-125,MMP-3 and VEGF has a certain value in the diagnosis of endometriosis,moreover,which can be regarded as noninvasive auxiliary examination method.