子宫内膜异位症患者血清PAI-1、sHLA-G、MMIF表达及临床诊断

Expression of serum plasminogen activator inhibitor-1,soluble human leukocyte antigen-G,and macrophage mobility inhibitor of women with endometriosis and their significance for clinical diagnosis

目的:探讨子宫内膜异位症(Ems)患者血清纤溶酶原激活物抑制因子-1(PAI-1)、可溶性人类白细胞抗原-G(sHLA-G)、巨噬细胞移动抑制因子(MMIF)表达及临床诊断意义。方法:选择2019年1月-2020年6月本院接诊的Ems患者68例为Ems组,同期体检健康妇女65例为对照组,分析两组血清PAI-1、sHLA-G、MMIF水平,采用受试者工作特征曲线(AUC)分析血清PAI-1、sHLA-G、MMIF诊断Ems价值。结果:Ems组血清PAI-1(193.56±61.68 mg/L)、sHLA-G(10.68±1.74μg/L)、MMIF(2.01±0.42 ng/ml)水平高于对照组,且Ⅱ期<Ⅲ期<Ⅳ期患者,轻度痛经<中度痛经<重度痛经患者(均P<0.05);预测子宫内膜异位症的AUC,PAI-1为0.983,95%CI为0.935~1.000;sHLA-G为0.986,95%CI为0.975~0.993,MMIF为0.981,95%CI为0.959~0.992;3项联合检测(0.996,95%CI为0.993~1.000)高于单独检测(P<0.05),此时特异度(93.2%)、准确度(94.3%)均高于单独检测。结论:在子宫内膜异位症患者中血清PAI-1、sHLA-G、MMIF的表达与不同分期、痛经程度存在密切关系,对子宫内膜异位症有较高预测价值。

Objective:To study the expression of serum plasminogen activator inhibitor-1(PAI-1),soluble human leukocyte antigen-G(sHLA-G),macrophage mobility inhibitor(MMIF)of women with endometriosis,and to study their significance for clinical diagnosis in endometriosis(Ems).Methods:68 women with Ems were included in study group from January 2019 to June 2020.In addition,65 healthy women were selected in control group during the same period.The levels of serum PAI-1,SHla-G,and MMIF of the women in the two groups were analyzed.The serum PAI-1,SHla-g and MMIF levels for diagnosing Ems was analyzed by receiver operating characteristic(ROC)curve.Results:The serum levels of PAI-1(193.56±61.68 mg/L),SHLA-G(10.68±1.74μg/L),and MMIF(2.01±0.42 ng/ml)of the women in the study group were significant higher than those of the women in the control group.The serum levels of PAI-1,SHLA-G,and MMIF of the women with II stage of Ems were the lowest,and then followed by those of the women with III stage of Ems,and those of the women with IV stage of Ems were the highest.The serum levels of the PAI-1,the SHLA-G,and the MMIF of the women with mild dysmenorrhea were the lowest,and then followed by those of the women with moderate dysmenorrhea,and those of the women with severe dysmenorrhea were the highest(all P<0.05).The AUC of the PAI-1 level for predicting Ems was 0.983,and its 95%CI was 0.935-1.000.The AUC of the sHLA-G level for predicting Ems was 0.986,and its 95%CI was 0.975-0.993.The AUC of MMIF for predicting Ems was 0.981,and its 95%CI was 0.959-0.992.The AUC of combined detection levels of the PAI-1,the sHLA-G,and the MMIF for predicting Ems was 0.996,and its 95%CI was 0.993-1.000,which were significant higher than those of the PAI-1 level,the sHLA-G level,or the MMIF level alone(P<0.05).The specificity(93.2%)and the accuracy(94.3%)of combined detection levels of the PAI-1,the sHLA-G,and the MMIF for predicting Ems were both significant higher than those of the PAI-1 level,the sHLA-G level,or the MMIF level alone.Conclusion:The expression levels of serum PAI-1,SHla-g,and MMIF of the women with Ems are closely related to their different stages of Ems and their severe degree of dysmenorrhea,so the levels of the serum PAI-1,SHla-g,and MMIF have high predictive value for Ems.