外周血Th17细胞在卵巢子宫内膜异位患者中的作用

Role of Peripheral Blood Th17 Cells in Patients with Ovarian Endometriosis

目的探讨外周血Th17细胞在卵巢子宫内膜异位患者中的作用.方法选取2014年1月~2018年9月到笔者医院就诊的经腹腔镜术后病理确诊为卵巢子宫内膜异位的患者185例为观察组,同时选取住院手术经病理检查为卵巢囊肿的非子宫内膜异位患者60例,另选取同期在笔者医院行健康体检的健康女性为对照组(60例).根据观察组患者病情严重程度进行分期,将其分为Ⅰ期(41例)、Ⅱ期(46例)、Ⅲ期(48例)及Ⅳ期(50例).检测各组外周血Th17细胞、白介素-17(IL-17)及C反应蛋白(CRP)水平,同时qRT-PCR检测观察组在位、异位和卵巢囊肿组在位内膜Th17特异性转录因子RORy-γt mRNA水平;采用受试者工作特征曲线(ROC)评估外周血Th17细胞对卵巢子宫内膜异位病情分期的评估效能.结果观察组患者外周血Th17细胞和IL-17水平显著高于卵巢囊肿组及健康对照组(P<0.05).在不同期别组间外周血Th17细胞和IL-17比较,差异有统计学意义(P<0.05),其中,Ⅳ期组外周血Th17细胞和IL-17水平最高,Ⅲ期、Ⅱ期及Ⅰ期组逐渐降低.与卵巢囊肿组比较,卵巢子宫内膜异位患者在位、异位内膜组织RORy-γt mRNA表达水平明显升高,同时异位内膜组织RORy-γt mRNA表达水平显著高于在位内膜,差异有统计学意义(P<0.05).外周血Th17细胞>6.9%为评估卵巢子宫内膜异位病情分期界限时,其曲线下面积(AUC)为0.843(95%CI:0.752 ~0.908),敏感度和特异性分别83.4%和79.0%.结论外周血Th17细胞及其相关细胞因子在卵巢子宫内膜异位患者中明显升高,其可能与卵巢子宫内膜异位的发生、发展过程密切相关.

Objective To investigate the role of peripheral blood Th 17 cells in patients with ovarian endometriosis. Methods Totally 185 patients who were diagnosed as ovarian endometriosis after laparoscopic surgery from January 2014 to September 2018 were enrolled as observation group, and 60 patients who were diagnosed as ovarian cyst by pathological examination were enrolled, 60 healthy women who received healthy physical examination in our hospital as the control group. According to the severity of the patients in the observation group, who were divided into stage I (41 cases), stage U (46 cases), stage DI (48 cases) and stage IV (50 cases). The levels of Th17 cells, interleukin - 17(IL - 17) and C - reactive protein( CRP) in peripheral blood of each group were detected, and the level of Th 17 - specific transcription factor RORy -γt mRNA was detected by qRT - PCR. The efficacy of peripheral blood Th17 cells in staging of ovarian endometriosis was evaluated by receiver operating characteristic curve( ROC). Results The Th 17 cells and IL - 17 levels in peripheral blood were significantly higher in the observation group than those in the ovarian cyst group and the healthy control group (P < 0. 05 ). The Th 17 cells and IL - 17 levels in peripheral blood in different stage groups were different, and the difference was signifi? cant( P < 0. 05 ), among them , the Th 17 cells and IL - 17 levels in peripheral blood in stage IV were highest, and which were gradually reduced in stage III , II and I . Compared with the ovarian cyst group, the mRNA levels of RORy -γt was significant increased in the eutopic and ectopic endometrium of ovarian endometriosis, and the expression level of RORy -γt mRNA in ectopic endometrium was significantly higher than that in eutopic endometrium, the difference was statistically significant ( P < 0. 05 ). When peripheral blood Th 17 cells >6. 9% were used to assess the stage of endometriosis of ovary, the AUC was 0. 843(95% CI :0. 752 - 0. 908), and the sensitivity and specificity were 83. 4% and 79.0%, respectively. Conclusion The Th 17 cells and related cytokines in peripheral blood were significant increased in patients with ovarian endometriosis, which may be closely related to the occurrence and development of ovarian endometriosis.