Th17细胞在子宫内膜异位症患者外周血与病灶组织中的分布差异及其致病机制的研究

Distribution of Th17 cells in peripheral blood and lesion tissues of patients with endometriosis and its pathogenesis.

目的研究子宫内膜异位症患者的异位内膜组织和外周血中Th17细胞的分布特点,探讨Th17细胞在子宫内膜异位症发病过程中的作用机制。方法回顾性选取2018年10月至2020年12月于南京医科大学附属苏州医院就诊的150例子宫内膜异位症的患者作为观察组,选取150例同期子宫良性病变术中行卵巢切除,且术中未见子宫内膜异位病灶、术后病理诊断排除内膜异位症患者作为对照组。统计对比2组患者外周血及内膜组织中Th17细胞的数量分布,外周血白细胞介素17(IL-17)及癌抗原125(CA125)的表达情况;统计观察组(子宫内膜异位症)患者治疗前、治疗4、8、12周后外周血中趋化因子[调节活化正常T细胞表达与分泌的趋化因子(RANTES)、单核细胞趋化蛋白-1(MCP-1)及巨噬细胞炎性蛋白-1(MIP-1)]、血管内皮生长因子(VEGF)及其受体的表达。结果观察组外周血、内膜组织中Th7细胞水平为(8.42±1.43)%、(9.14±2.01)%,均显著高于对照组[(0.62±0.13)%、(0.56±0.22)%],差异均有统计学意义(P<0.05)。观察组血清IL-17、CA125水平为(358.42±1.43)、(59.65±8.24)pg/mL,均显著高于对照组[(204.62±0.13)、(12.31±2.83)pg/mL],差异均有统计学意义(P<0.05)。观察组患者治疗4、8、12周后血清RANTES、MCP-1、MIP-1、VEGF及其受体的表达水平均明显低于治疗前,差异均有统计学意义(P<0.05)。结论Th17细胞数量和其相关趋化因子及趋化因子受体在子宫内膜异位症患者外周血及病灶中表达显著升高,提示Th17细胞与子宫内膜异位有关,可作为临床子宫内膜异位症诊断和判断治疗效果的一个重要指标。

Objective To study the distribution of Th17 cells in ectopic endometrium and peripheral blood of patients with endometriosis,and to summarize and analyze the mechanism of Th17 cells in the pathogenesis of endometriosis.Methods A total of 150 patients with endometriosis treated in Nanjing Medical University Affiliated Suzhou Hospital from October 2018 to December 2020 were retrospectively selected as the observation group,and 150 patients without endometriosis during the same period were selected as the control group.The number and distribution of Th17 cells in peripheral blood and intimal tissue and the expression of interleukin-17(IL-17)and cancer antigen 125(CA125)in peripheral blood were statistically compared between the two groups;The expressions of chemokines[regulated upon activation normal T cell expressed and secreted(RANTES),monocyte chemoattractant protein-1(MCP-1),macrophage inflammatory protein-1(MIP-1)],vascular endothelial growth factor(VEGF)and their receptors in peripheral blood of patients in the observation group(endometriosis)before,after 4,8,and 12 weeks of treatment were counted and analyzed.Results The levels of Th7 cells in the peripheral blood and intimal tissues of the observation group were(8.42±1.43)%and(9.14±2.01)%,which were significantly higher than those of the control group[(0.62±0.13)%,(0.56±0.22)%],the difference were statistically significant(P<0.05).The levels of serum IL-17 and CA125 in the observation group were(358.42±1.43)and(59.65±8.24)pg/mL,which were significantly higher than those in the control group[(204.62±0.13),(12.31±2.83)pg/mL],the differences were statistical significance(P<0.05).The expression levels of serum RANTES,MCP-1,MIP-1,VEGF and their receptors in the observation group after 4,8,and 12 weeks of treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).Conclusion The number of Th17 cells and their related chemokines and chemokine receptors are significantly increased in peripheral blood and lesions of patients with endometriosis,suggesting that Th17 cells are related to endometriosis,which can be used as an important indicator for clinical diagnosis and treatment.