子宫内膜异位症患者外周血MCP-1、sflt-1、sICAM-1的变化及意义

The changes and significance of levels of peripheral blood MCP-1, sFlt-1 and sICAM-1 of women with endometriosis

目的:探讨子宫内膜异位症患者外周血单核细胞趋化蛋白-1(MCP-1)、可溶性血管内皮生长因子受体-1(sflt-1)、可溶性细胞粘附分子-1(sICAM-1)的变化及意义。方法:选择本院收治的60例子宫内异位症患者(2016年11月~2018年11月)为异位症组,同期接受体检的60例健康育龄女性为对照组。比较两组及不同分期子宫内膜异位症患者外周血MCP-1、sflt-1、sICAM-1的表达及在疾病中的变化意义。结果:异位症组外周血MCP-1、sflt-1、sICAM-1均高于对照组[(38.94±4.10)ng/ml比(11.32±1.54)ng/ml,(231.92±23.42)pg/ml比(95.34±14.17)pg/ml,(349.53±32.40)ng/ml比(212.01±25.93)ng/ml](P<0.05);Ⅲ~Ⅳ期子宫内膜异位症患者外周血MCP-1、sflt-1、sICAM-1高于Ⅰ~Ⅱ期患者(P<0.05);经Pearson单因素分析显示,MCP-1与sflt-1、sICAM-1均呈正相关,sflt-1与sICAM-1也呈正相关(P<0.05);外周血MCP-1诊断子宫内膜异位症的AUC为0.788,sflt-1的AUC为0.798,sICAM-1的AUC为0.759,联合检测的AUC为0.934,联合检测AUC高于各指标单独检测,且特异度、准确度(90.34%、92.10%)均高于各单独检测指标(P<0.05)。结论:在子宫内膜异位症患者中,外周血MCP-1、sflt-1、sICAM-1表达明显升高,联合检测可作为诊断、监测病情及预后的可靠指标。

Objective: To study the changes and significance of the levels of peripheral blood monocyte chemoat-tractant protein-1 (MCP-1), soluble vascular endothelial growth factor receptor-1 (sFlt-1) and Soluble cell adhesion molecule-1 (sICAM-1) of women with endometriosis. Methods: 60 women with endometriosis were selected in the study group from November 2016 to November 2018, and other 60 healthy child-bearing age women were selected into the control group during the same period. The expression of peripheral blood MCP-1, sFlt-1 and sICAM-1 of women were compared between the two groups, and the changes and significance of the levels of peripheral blood MCP-1, sFlt-1 and sICAM-1 of women in both groups were analyzed. Results: The levels of peripheral blood MCP-1, sFlt-1, and sICAM-1 of women in the study group were 38.94±4.10 ng/ml, 231.92±23.42 pg/ml, and 349.53±32.40 ng/ml, respectively, which were significant higher than those (11.32±1.54 ng/ml, 95.34±14.17, and 212.01±25.93ng/ml) of patients in the control group( P <0.05). The levels of MCP-1, sFlt-1 and sICAM-1 of women with endometriosis III-IV stage were significant higher than those of patients with I-II stage ( P <0.05). Pearson single factor analysis showed that MCP-1 level was positively correlated with levels of sFlt-1 and sICAM-1 ( P <0.05), and sFlt-1 level and were also positively correlated with sICAM-1 level ( P <0.05). The AUC of MCP-1, sflt-10, and sICAM-1 levels for diagnosing endometriosis were 0.788, 0.798, and 0.759, respectively. The AUC of the MCP-1 level combined with sflt-10 level and sICAM-1 level was 0.934, which was significant higher than that of MCP-1 level, sflt-10 level, or sICAM-1 level only. The specificity and accuracy of MCP-1 level combined with sflt-10 level and sICAM-1 level for diagnosing endometriosis were 90.34% and 92.10%, which were significant higher than those of MCP-1 level, sflt-10 level, or sICAM-1 level only ( P <0.05). Conclusion: The expressions of peripheral blood MCP-1, sFlt-1 and sICAM-1 of patients with endometriosis increase significantly, which involve in the occurrence and development of endometriosis. The level of peripheral blood MCP-1 combined with sflt-10 level and sICAM-1 level can serve as a reliable index for diagnosing and predicting prognosis of women with endometriosis.