子宫内膜异位症患者月经血中PR-B基因甲基化状态无创检测

oninvasive detection of methylation of progesterone receptor B in menstrual blood in patients with endometriosis

目的:探讨子宫内膜异位症患者月经血中孕激素受体B亚型(PR-B)的甲基化状态无创诊断检测。方法:收集本院2016-2017年因卵巢子宫内膜异位囊肿行手术的40例患者(异位组)异位、在位内膜和术后第一次月经血,同时收集因输卵管因素不孕行宫腹腔镜检查的18例患者(对照组)子宫内膜和术后第一次月经血。采用甲基化荧光PCR方法测定两组内膜及月经血中PR-B的甲基化状态。结果:异位组在位内膜(55%)和月经血(47.5%)中PR-B启动子区域的甲基化率显著高于对照组内膜(22.2%)和月经血(16.7%)(P<0.05)。异位组在位内膜与月经血、对照组子宫内膜与月经血中PR-B的甲基化状态均呈正相关(r=0.558、0.478,P=0.000、0.045)。结论:子宫内膜中PR-B的异常甲基化可能参与了子宫内膜异位症的发生,而这种异常甲基化可从月经血中内膜碎片检测出,为临床无创诊断提供了新思路。

Objective: To investigate the noninvasive detection of methylation of progesterone receptor B(PR-B) status in menstrual effluent of patients with endometriosis. Methods: 40 patients with ovarian endometriosis cyst were selected in study group, and 18 infertility patients who undergone hysteroscopy and laparoscopy examination were included in control group from 2016 to 2017. The endometrium, eutopic endometrium, and the first menstrual effluent after operation of women in the two groups were collected and the methylation status of PR-B was detected by methylation fluorescence PCR. Results: The methylation rate of PR-B promoter region in eutopic endometrium and menstrual effluent of patients in the study group were 55% and 47.5%, which were significant higher than those(22.2% and 16.7%) of patients in the control group(P<0.05). The methylation status of PR-B in eutopic endometrium and menstrual blood of patients in the study group were positively correlated with the methylation status of PR-B and in endometrium and menstrual effluent of patients in the control group(r=0.558, 0.478, P=0.000, 0.045). Conclusion: Abnormal methylation of PR-B in endometrium maybe involved in the occurrence of endometriosis, and this abnormal methylation can be detected from the endometrial debris in menstrual effluent, so it maybe a new idea for non-invasive diagnosis of endometriosis.