血清及腹腔液中IL-6、IL-37、TNF-α水平与子宫内膜异位症不孕关系

The relationship between the levels of IL-6,IL-37 and TNF-αin serum and peritoneal fluid in women with endometriosis and infertility

目的:分析子宫内膜异位症(EMT)患者血清与腹腔液中白细胞介素-6(IL-6)、IL-37、肿瘤坏死因子(TNF-α)水平,以及与EMT及其不孕关系。方法:回顾性收集本院2017年11月-2020年3月行腹腔镜手术经病理证实为EMT患者82例临床资料,其中单纯EMT 45例、EMT合并不孕37例;同期行卵巢囊肿、畸胎瘤与子宫肌瘤手术治疗50例为对照组。观察分析3组患者血清及腹腔液中IL-6、IL-37、TNF-α水平变化及与EMT和不孕的关系。结果:血清及腹腔液中IL-6、IL-37、TNF-α水平EMT合并不孕组高于单纯EMT组,且两组均高于对照组(P<0.05)。ROC曲线分析显示,血清IL-6、IL-37、TNF-α预测EMT与EMT合并不孕患者的AUC分别为0.719、0.698、0.730,3项联合的AUC为0.880;腹腔液IL-6、IL-37、TNF-α预测EMT与EMT合并不孕患者的AUC分别为0.741、0.675、0.734,3项联合的AUC为0.894。Pearson相关性分析显示,血清及腹腔液中IL-6、IL-37、TNF-α均呈现正相关关系。结论:血清与腹腔液中IL-6、IL-37、TNF-α水平与EMT发病及EMT合并不孕有密切关系,且3者相互呈正相关关系。

Objective:To analyze the levels of interleukin-6(IL-6),interleukin-37(IL-37),and tumor necrosis factor(TNF-α)in serum and peritoneal fluid of women with endometriosis(EMT),and to explore their relevant to the infertility of the women.Methods:The clinical data of 82 women with EMT confirmed by pathology after laparoscopic surgery from November 2017 to March 2020 were retrospectively analyzed,which included 35 women with EMT only in group A and 37 women with EMT complicated with infertility in group B.50 women after surgery because of ovarian cyst,teratoma,and uterine fibroid during the same period were selected in group C.The changes of the levels of IL-6,IL-37 and TNF-αin serum and peritoneal fluid of the women in three groups were observed and analyzed,and which relevant to infertility of these women was analyzed.Results:The levels of IL-6,IL-37 and TNF-αin serum and peritoneal fluid of the women in group B were significant higher than those of the women in group A,and which of the women in group B and group A were significant higher than those of the women in group C(P<0.05).ROC curve analysis showed that the AUC of the serum IL-6 level,IL-37 level,and TNF-αlevel for predicting infertility of the women with EMT were 0.719,0.698,and 0.730,respectively,and the AUC of the combined detections of the serum IL-6,IL-37 and TNF-αlevels for predicting infertility of the women with EMT was 0.880.The AUC of peritoneal fluid IL-6 level,IL-37 level,and TNF-αlevel for predicting infertility of the women with EMT were 0.741,0.675,and 0.734,respectively,and the AUC of the combined detection of the peritoneal fluid IL-6,IL-37 and TNF-αlevels was 0.894.Pearson correlation analysis showed that the level of IL-6,IL-37 or TNF-αin serum and peritoneal fluid were positively correlated each other.Conclusion:The levels of IL-6,IL-37 and TNF-αin serum and peritoneal fluid of the women were closely association with their EMT occurrence and the incidence of infertility,and their levels of IL-6,IL-37,and TNF-αin serum and peritoneal fluid are positively correlated with each other.