Apelin在子宫内膜增生及癌变患者血清中的表达研究

Expression of Apelin in the serum of patients with endometrial hyperplasia and cancer

目的 通过检测子宫内膜增生(EH)及子宫内膜癌(EC)患者血清中Apelin表达水平,分析其与EH/EC发病之间的关系,为EH/EC的发病机制提供新的研究依据。方法 选取2018年3月至2019年10月因异常子宫出血或超声异常就诊于天津医科大学总医院,病理结果诊断为EH/EC的患者34例为EH/EC组;选取同期因宫腔粘连或助孕检查就诊,病理结果诊断为增殖期或分泌期子宫内膜者49例为对照组,收集相关临床病例资料,检测空腹血糖(FPG)、胰岛素、性激素6项及血清Apelin水平。结果 EH/EC患者血清Apelin水平明显高于对照组[(377.25±229.64)μg/L vs.(151.98±96.33μg/L),P<0.001];亚组分析显示,EH/EC胰岛素抵抗(IR)组血清Apelin水平明显高于IR对照组[(411.79±288.70)μg/L vs.(160.48±105.32)μg/L,P=0.036]和非IR对照组[(411.79±288.70)μg/L vs.(148.91±94.27)μg/L,P=0.001];非IR EH/EC组Apelin血清表达水平明显高于IR对照组[(346.55±163.42)μg/L vs.(160.48±105.32)μg/L,P=0.014]和非IR对照组[(346.55±163.42)μg/L vs.(148.91±94.27)μg/L,P<0.001];Pearson相关性分析显示,Aplin表达水平与体重指数(BMI)、FPG呈正相关;ROC曲线显示血清Apelin诊断EH/EC的最佳阈值为251.80μg/L(P<0.001);多因素logistic回归分析显示,血清Apelin水平≥251.80μg/L是EH/EC的独立危险因素(OR=17.52,95%CI 4.970~67.110,P<0.001)。结论 EH/EC患者Apelin血清表达水平显著升高;Apelin表达水平与BMI、FPG水平相关;血清Apelin水平≥251.80μg/L可能与EH/EC患病风险显著增加有关,提示Apelin可能是EH/EC潜在的生物学治疗靶点。

Objective To detect serum Apelin levels of patients with EH/EC and to analyze its relationship with the pathogenesis of EH/EC to provide a new research basis for the pathogenesis of EH/EC.Methods Between March 2018and October 2019,34 patients visited Tianjin Medical University General Hospital for abnormal uterine bleeding or ultrasound abnormalities with pathological findings being endometrial hyperplasia or carcinoma(EH/EC)and they were selected as the case group(EH/EC group);49 patients who visited the hospital for uterine adhesions or adjuvant pregnancy tests with pathological findings being proliferative or secretory stage endometrium were selected as the control group,and relevant clinical data were collected,and fasting glucose,insulin,sixitems of sex hormone and serum Apelin levels were determined.Results EH/EC patients expressed higher serum levels of Apelin than the controls[(377.25±229.64)μg/L vs.(151.98±96.33)μg/L,P<0.001];subgroup analysis showed that the serum Apelin levels in EH/EC IR group were significantly higher than IR control group[(411.79±288.70)μg/L vs.(160.48±105.32)μg/L,P=0.036]and Non-IR control group[(411.79±288.70)μg/L vs.(148.91±94.27)μg/L,P=0.001];the serum Apelin levels in non-IR EH/EC group were significantly higher than those in IR control group[(346.55±163.42)μg/L vs.(160.48±105.32)μg/L,P=0.014]and non-IR control group[(346.55±163.42)μg/L vs.(148.91±94.27)μg/L,P<0.001];Pearson’s correlation coefficient analysis showed that serum Aplin levels were positively correlated with BMI and FPG;ROC curve showed that the best threshold of serum Apelin to diagnose EH/EC was 251.80μg/L (P<0.001);multivariate logistic regression showed that the serum Apelin levels≥251.80μg/L was an independent risk factor for EH/EC(OR=17.52,95%CI 4.970-67.110,P<0.001).Conclusion The serum Apelin levels have a dramatic increase in EH/EC patients;serum Apelin levels correlate with BMI and FPG levels;serum Apelin levels≥251.80μg/L may be related to a significant increase of the risk of EH/EC.The above results suggest that Apelin may be a potential bioligical therapy target for EH/EC.