卵巢子宫内膜异位囊肿患者血清及卵巢组织中AMH的表达

Expression of AMH in serum and ovarian tissues of patients with endometrioma

目的 检测卵巢子宫内膜异位囊肿患者血清及卵巢组织的抗苗勒管激素(AMH)表达水平,并与健康人及其他卵巢良性囊肿患者进行对比,以判断异位囊肿本身对患者卵巢储备的影响.方法 选择2016年7月至2017年8月在海南省人民医院妇科住院行手术治疗的单侧卵巢子宫内膜异位囊肿患者20例(实验组),因单侧其他卵巢良性囊肿住院行手术治疗的患者20例(对照组A)和健康女性20例(对照组B).抽取所有受检者的外周静脉血,测定AMH水平.卵巢囊肿患者在行卵巢囊肿剔除术中,取囊肿旁的一小部分正常卵巢组织,采用免疫组化的方法 检测卵巢组织中AMH抗原表达,采用荧光定量RT-PCR的方法 检测卵巢组织中AMH mRNA相对表达量;对照组B仅检测血清AMH水平.结果 三组受检者间的年龄比较差异无统计学意义(P>0.05);实验组和对照组A患者的囊肿大小比较差异无统计学意义(P>0.05);实验组患者的血清AMH水平为(2.34±0.98)ng/mL,明显低于对照组A的(3.14±0.73)ng/mL及对照组B的(3.46±1.02)ng/mL,差异均有统计学意义(P<0.05),而对照组A与对照组B间的血清AMH水平比较差异无统计学意义(P>0.05);实验组患者卵巢组织中的AMH阳性表达率为53.3%,明显低于对照组A的80.0%,差异有统计学意义(P<0.05);荧光定量RT-PCR显示,实验组患者的AMH mRNA的相对表达量为0.48±0.16,明显低于对照组A的0.63±0.21,差异有统计学意义(P<0.05).结论 异位囊肿患者的血清和卵巢组织中的AMH的水平均明显低于健康人和其他卵巢良性囊肿患者,异位囊肿对周边卵巢组织存在损伤,进而影响了卵巢储备功能,对异位囊肿患者早诊断早治疗或许可保护患者的卵巢功能.

Objective To evaluate the expression of anti-Müllerian hormone(AMH)in serum and ovarian tissues of patients with endometrioma,compared with that in healthy people and other patients with benign ovarian cysts to determine the impact of endometrioma on ovarian reserve.Methods A total of 20 women with unilateral endometrioma undergoing surgical treatment from July 2016 to August 2017 in Hainan General Hospital were enrolled,as the experimental group.In the same period,20 women with other unilateral ovarian benign cyst undergoing surgical treatment were enrolled as the control group A,and 20 healthy women were selected as control group B.Serum AMH levels were determined in all women of the three groups.Immunohistochemistry was used to detect AMH protein expression,and quantitative RT-PCR was used to detect AMH mRNA expression in ovarian tissues.Results There was no statistical difference in age between the three groups(P>0.05).There was no statistical difference in the size of cyst between the experimental group and the control group A(P>0.05).Serum AMH level in the experimental group was(2.34±0.98)ng/mL,which was significantly lower than(3.14±0.73)ng/mL in the control group A and(3.46±1.02)ng/mL in the control group B(P<0.05);while there was no significant difference between the control group A and the control group B(P>0.05).The positive expression rate of AMH protein in the ovarian tissues of the experimental group was 53.3%,which was significantly lower than 80.0%in the control group A.Quantitative RT-PCR showed that the relative expression of AMH mRNA in the experimental group was 0.48±0.16 versus 0.63±0.21 in the control group A(P<0.05).Conclusion The expression levels of AMH in serum and ovarian tissues of patients with endometrioma was significantly lower than that in healthy people and other patients with benign ovarian cysts.Endometrioma has adverse effect on ovarian reserve.Early diagnosis and intervention may protect patients'ovarian function.