子宫内膜异位症患者血清sICAM-1含量测定及临床意义

SERUM SOLUBLE CELL ADHESION MOLECULE-1 IN ENDOMETRIOSIS

目的 :探讨子宫内膜异位症 (内异症 )患者血清可溶性细胞粘附分子 - 1(sICAM - 1)水平的变化及其临床意义。方法 :采用双抗夹心酶联免疫吸附法 (ELISA)测定了 6 0例内异症患者 (其中Ⅰ期 8例、Ⅱ期 12例、Ⅲ期 18例及Ⅳ期 2 2例 )及 30例对照组妇女之血清sICAM - 1和CA12 5水平 ;以及 4 5例内异症患者经腹腔镜保守性手术治疗前后血清sICAM - 1及CA12 5水平的变化。结果 :内异症组血清sICAM - 1的水平高于对照组 ,差异有显著性 (P <0 .0 5 ) ;其中内异症Ⅲ、Ⅳ期与对照组相比 ,差异有显著性 (P <0 .0 5 )和极显著性 (P <0 .0 1) ;内异症患者血清sICAM - 1水平与其RAFS评分呈直线正相关 ,r值为 0 .5 94 (P <0 .0 1) ;血清sICAM- 1(临界值 4 4 0ng/ml)诊断内异症的敏感性 6 6 .6 7% ,特异性 86 .6 7% ;血清CA12 5 (临界值 35u/ml)诊断内异症的敏感性 36 .6 7% ,特异性 86 .6 7% ;内异症患者血清sICAM - 1水平于手术治疗前后比较 ,差异有极显著性 (P <0 ,0 1)。结论 :sICAM - 1在内异症的发生发展中起重要作用 ,血清sICAM - 1可望成为内异症诊断和手术治疗监测更有价值的免疫学指标。

Objective:To evaluate the changes of serum soluble cell adhesion molecule-1(sICAM-1) in endometriosis(EMs) and their clinical significance. Method:The sICAM-1 and CA125 levels in serum of 60 endometriotic patients(8 women with stage Ⅰ ,12 women stage Ⅱ, 18 women stage Ⅲ and 22 women stage Ⅳ) and 30 control patients were determined by ELISA,and the serum changes were measured by ELISA before and after conservative laparoscopic surgery in patients with EMs.Results:The serum sICAM-1 levels in EMs were higher than those in control women ( P <0.05) . And serum sICAM-1 levels in stage Ⅲ or Ⅳ of EMs were higher or significantly higher than those in control group ( P <0.05 or P <0.01).Significant parallel relationship existed between the stage of EMs and the serum sICAM-1 levels in EMs patients (r value: 0.594, P <0.01).Suppose the normal range of concentration of serum sICAM-I was 0～440ng/ml,then the sensitivity of EMs in this research was 66.67%, the specificity was 86.67%; if the diagnosis standard of EMs by CA125 was above 35u/ml, then the sensitivity was 36.67%, the specificity was 86.67%.After clearance of endometriosis foci with laparoscopic conservative surgery, the serum sICAM-1 levels decreased significantly ( P <0.01).Conclusions:The sICAM-1 may play an important role in the pathogenesis and progression of EMs. Serum sICAM-1 may be regarded as a significant diagnostic or therapeutic index in EMs.