子宫内膜异位症患者血清miRNA-93水平与不孕的相关性分析

Study on Relationship between Serum miR-93 Level and Infertility in Patients with Endometriosis

【目的】探讨子宫内膜异位症(Endometriosis,EMT)患者血清miRNA-93水平与不孕的相关性。【方法】选取2017年1月至2018年12月在本院妇科诊治的EMT患者98例(观察组),其中合并不孕症患者58例.未合并不孕症患者40例,美国生殖医学学会(American Society for Reproductive Medicine,ASRM)分期I期55例,D期31例,ID期8例,W期4例;另外选取同期在本院行常规妇科检查的育龄期健康妇女115例作为对照组。采用实时荧光定量聚合酶链反应(qRT-PCR)检测血清miRNA-93表达水平;采用受试者工作曲线(receiver operating characteristic,R0C)评估miRNA-93对EMT合并不孕的诊断价值;采用Logistic回归分析不孕的危险因素。【结果】观察组miRNA-93相对表达量为0.24±0.09,显著低于对照组的0.31±0.12,其差异具有统计学意义(t=—4.747,P<0.05)。EMT患者不孕者血清miRNA-93表达水平为0.21±0.06,显著低于非不孕者的0.28±0.11,其差异有统计学意义(r=-4.055,P=0.001)。EMT患者中ASRM分期Ⅰ期、Ⅱ期、Ⅲ期、IV期的miRNA-93相对表达量为0.21±0.07、0.25±0.06、0.34±0.08、0.38±0.04,随着ASRM分期的升高,miRNA-93表达水平下降,不同分期比较差异具有统计学意义(F=16.659,P<0.05)。ROC曲线分析显示:miRNA-93预测EMT合并不孕的最佳临界点为0.28,灵敏度为93.24%,特异度为55.32%,曲线下面积(AL7C)为0.695。多因素Logistic回归分析结果显示:miRNA-93是EMT患者不孕的独立危险因素。【结论】EMT患者血清miRNA-93表达水平下降,且下降程度与患者病情分期一致,合并不孕的EMT患者血清miRNA-93表达水平显著低于非不孕患者,这提示血清miRNA-93对于评估EMT疾病进展和不孕具有一定价值。

[Objective]To investigate the relationship between the level of serum miR 93 and nfertility in patients with endometriosis(EMT).[Methods]From January 2017 to December 2018,98 patients with endo-metriosis were selected as the observation group including inferility(n=59)and non-inferility(n=40),and 115 healthy women of childbearing age who had routine gynecological examination at the same time period were selected as the control group.According to the American Society for Reproductive Medicine(ASRM),EMT patients sub-divided into 55 cases in stage Ⅰ,31 instage Ⅱ,8instage Ⅲ,and 4 cin stage Ⅳ.The ex-pressionof milR-93 in serum was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR).The receiver operating characteristic(ROC)was used to evaluate the value of miR 93 in the diag-nosis of infertility in EMT.Logistic regression was used to analyze the risk factors of infertility.[Results]The expression level of miR 93 in the observation group(0.24±0.09)was significantly lower than that in the con-trol group(0.31±0.12)。and the difference was stsistically significant(P<0.05).The serum miR-93 ex-pression level of infertile EMT patients was 0.21±0.06,which was sigificantly lower than 0.28±0.11 of non-infertile patients,and the difference was statistically significant(t=4.055.P=0.001).The relative expression of miR-93 in ASRM stages Ⅰ,Ⅱ,Ⅲ,and Ⅳ in EMT patients was0.21±0.07(phase Ⅰ),0.25±0.06(phase Ⅰ),0.34±0.08(phase 0)and0.38±0.04(phase NV),respeetively.With the increaseof AS-RM stage,miR 93 expression level decreased;the difference was statistically significant in different stages(F=16.659,P<0.001).ROC curve analysis showed that the best cut-off value for miR-93 to predict infertility in EMT was 0.28;the sensitivity was 93.24%,the specificity was 55.32%,and the area under AUC curve was 0.695.Multivariate logistic regression showed that miR 93 was an independent risk factor of infertility(OR:1.13;95%CI;1.07~1.20).[Conclusion]The level of serum miR 93 expression in patients with EMT decreased,and the degree of decline was consistent with the stage of the disease.The level of serum rmiR-93 expression in patients with infertility was significantly lower than that in patients with non-infertility EMT,suggesting that this index has a certain value for the evaluation of the disease progress of EMT.