miR-141-3p、PD-L1及巨噬细胞在子宫内膜异位症中的表达及相关性研究

Expression and correlation of miR-141-3p, PD-L1 and macrophages in endometriosis

目的 探讨miR-141-3p、PD-L1及M1、M2型巨噬细胞在子宫内膜异位症(Endometriosis,EMs)中的表达及其临床意义。方法 选取2021年10月-2022年7月,因EMs在石河子大学第一附属医院妇科行腹腔镜手术或开腹手术的患者30例为EMs组,同期选取非EMs患者因子宫肌瘤行诊断性刮宫或子宫全切术的子宫内膜组织30例为对照组,术后病理证实均为增生期子宫内膜。通过qRT-PCR检测子宫内膜组织中miR-141-3p以及PD-L1的表达;通过免疫组化检测子宫内膜组织中M1型巨噬细胞表面标志物CD86,M2型巨噬细胞表面标志物CD206的表达,并应用Image J软件对免疫组化结果进行平均光密度(Average Optical Density,AOD)的检测。通过Person或Spearman相关检验分析miR-141-3p、PD-L1、CD86及CD206之间相关性。结果 (1) miR-141-3p在EMs组在位内膜、异位内膜中的表达低于对照组子宫内膜(P=0.000 5;P<0.000 1),且在异位内膜中表达最低。(2) PD-L1在EMs组在位内膜、异位内膜中的表达高于对照组子宫内膜(P=0.013 7;P=0.000 3),且在异位内膜中表达最高。(3)在EMs异位内膜中miR-141-3p与PD-L1的表达呈负相关(r=-0.648 9,P=0.000 1)。(4) CD86在EMs组在位内膜、异位内膜中的表达低于对照组子宫内膜(P=0.047 2;P=0.001 0)。(5) CD206在EMs组在位内膜、异位内膜中的表达高于对照组子宫内膜(P=0.043 4;P<0.000 1),且在异位内膜中表达最高。(6) PD-L1与M1型巨噬细胞标志物CD86在EMs异位内膜中的表达呈负相关(r=-0.440 8,P=0.014 8)。(7) PD-L1与M2型巨噬细胞标志物CD206在EMs异位内膜中的表达呈正相关(r=0.598 1,P=0.000 5)。结论 EMs患者中miR-141-3p表达降低,PD-L1表达升高,巨噬细胞从M1型向M2型极化,且随病情进展而改变。

Objective To investigate the expression and clinical significance of miR-141-31,PD-L1 and M1 and M2 macrophages in endometriosis(EMs).Methods From October 2021 to July 2022,30 patients with laparoscopic surgery or open surgery for EMs;30 patients with diagnostic cuttage or total resection for uterine fibroids were selected during the same period,and postoperative pathology confirmed proliferative endometrium.The expression of miR-141-3p and PD-L1 in endometrial tissue was measured by qRT-PCR,the expression of M1 macrophage CD86,M2 macrophage CD206 by immunohistochemistry and the average optical density(AOD)of immunohistochemistry using Image J software.Correlations between miR-141-3p,PD-L1,CD86,and CD206 were analyzed by Person or Spearman correlation analysis.Results(1)The expression of miR-141-3p was lower in the place and ectopic membranes than in the control group(P=0.0005;P<0.0001)and the lowest in the ectopic lining.(2)PD-L1 expression was higher in the place and ectopic endometrium in the EMs than in the control endometrium(P=0.0137;P=0.0003),and had the highest expression in the ectopic endometrium.(3)miR-141-3p and PD-L1 expression in the ectopic inner membrane of EMs(r=-0.6489,P=0.0001).(4)The expression of CD 86 was lower in the site and ectopic lining of the EMs group than in the endometrium of the control group(P=0.0472;P=0.0010).(5)CD206 expression was higher in the place and ectopic endometrium in the EMs than in the control group(P=0.0434;P<0.0001),and the expression was highest in the ectopic endometrium.(6)PD-L1 was negatively correlated with the expression of the M1 macrophage marker CD86 in the ectopic inner membrane of EMs(r=-0.4408,P=0.0148).(7)PD-L1 showed a positive correlation between the expression of the M2 type macrophage marker CD206 in the ectopic inner membrane of EMs(r=0.5981,P=0.0005).Conclusion miR-141-3p decreased,PD-L1 increased,and macrophages polarized from M1 to M2,which changed with the progression of the disease.