摘要
目的 检测子宫内膜异位症(EMs)患者子宫内膜组织中CD38、CD138的表达情况,探讨二者在EMs发病中的作用。方法 选取2020年7月至2021年7月于广西壮族自治区妇幼保健院妇科收治的育龄女性200例,其中通过检查确诊子宫内膜异位症患者100例作为观察组,排除子宫内膜异位症并需要行宫腔镜检查的育龄女性100例作为对照组。免疫组化实验检测两组患者子宫内膜组织中CD38和CD138的表达水平;酶联免疫吸附测定血清中辅助T细胞因子干扰素(INF)-γ、肿瘤坏死因子(TNF)-α、白介素(IL)-6和血管内皮细胞生长因子(VEGF)表达水平,同时检测外周血中炎症因子WBC、CRP、CA125数值。采用多因素Logistic回归方程分析EMs的相关影响因素,采用受试者操作特征(ROC)曲线分析CD38、CD138与INF-γ、IL-6、TNF-α、VEGF、WBC、CRP、CA125对EMs的预测价值。结果 观察组子宫内膜组织中CD38、CD138阳性比例,血清中TNF-α、IL-6、VEGF和外周血中WBC、CRP、CA125高于对照组(P<0.05);血清中INF-γ低于对照组(P<0.05)。Logistic分析显示,CD38、CD138、TNF-α、IL-6、VEGF、WBC、CRP、CA125是影响EMs的危险因素,INF-γ是影响EMs的保护因素;CD38、CD138是影响EMs的独立危险因素。ROC曲线结果显示,CD38、CD138、TNF-α、IL-6、VEGF、INF-γ、WBC、CRP、CA125预测EMs的曲线下面积(AUC)为0.982、0.985、0.775、0.769、0.616、0.202、0.930、0.857、0.791。结论 EMs患者病灶组织中CD38、CD138高表达,与血清中的炎症因子以及机体免疫因子密切相关,建议临床上采用IHC技术检测CD38、CD138,可提高诊断的准确率,为子宫内膜异位症患者的系统性治疗提供指导作用。
Objective To detect the expression of CD 38 and CD 138 in the lesion tissue of patients with endometriosis(EMs), and to explore their roles in the pathogenesis of EMs. Methods A total of 200 women of childbearing age admitted to the department of gynecology of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from July 2020 to July 2021 were selected, including 100 patients with endometriosis confirmed by examination as the observation group, and 100 women with endometriosis excluded and requiring hysteroscopy as the control group. Immunohistochemistry was used to detect the expression of CD38 and CD138 in endometrial tissues of the two groups. The levels of interferon(INF)-γ, tumor necrosis factor(TNF)-α, interleukin(IL)-6 and vascular endothelial cell growth factor(VEGF) in serum were determined by enzyme-linked immunosorbent assay. The values of inflammatory factors WBC, CRP and CA125 in peripheral blood were also detected. Multivariate Logistic regression equation was used to analyze the related influencing factors of EMs.Receiver operating characteristic(ROC) curve was used to analyze the predictive value of CD 38, CD 138, INF-γ, IL-6, TNF-α,VEGF, WBC, CRP and CA125 on EMs. The levels of CD38 and CD138 in endometrial tissue were detected by IHC, and the levels of T helper cytokine interferon in serum were determined by ELISA. Results The positive rates of CD 38 and CD 138 in endometrial tissues, TNF-α, IL-6, VEGF in serum and WBC, CRP and CA125 in peripheral blood in observation group were higher than those in control group(P<0.05). The level of INF-γ in serum was lower than that in control group(P<0.05). Logistic analysis showed that CD38, CD138, TNF-α, IL-6, VEGF, WBC, CRP and CA125 were risk factors for EMs, INF-γ was a protective factor for EMs. CD38 and CD138 are independent risk factors for EMs. ROC curve results showed that, the area under curve(AUC) of CD38, CD138, TNF-α, IL-6, VEGF, INF-γ, WBC, CRP and CA125 to predict EMs were 0.982, 0.985,0.775, 0.769, 0.616, 0.202, 0.930, 0.857, 0.791. Conclusion The high expression of CD38 and CD138 in the lesion tissues of EMs patients is closely related to the inflammatory factors in serum and immune factors of the body. It is suggested to use IHC technology to detect CD38 and CD138 in clinical practice, which can improve the accuracy of diagnosis and provide guidance for the systematic treatment of endometriosis patients.
作者
张莉
蒋丽
莫梅珍
ZHANG Li;JIANG Li;MO Meizhen(Department of Gynecology,Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530000,China)
出处
《中国优生与遗传杂志》
2022年第12期2144-2149,共6页
Chinese Journal of Birth Health & Heredity
基金
广西卫健委自筹经费科研课题(Z20200654)。
