血管内皮生长因子及其可溶性受体在子宫内膜异位症患者血清、腹腔液中的表达及意义

摘要

目的：观察血管内皮生长因子( vascular endothelial growth factor, VEGF)、血管内皮生长因子可溶性受体-1(soluble vascular endothelial growth factor receptor -1, sVEGFR -1)在子宫内膜异位症( endometriosis,EMs)患者血清、腹腔液中的表达,并探讨其临床意义。方法选取2013年2月至2015年8月在黄石市妇幼保健院住院行腹腔镜手术治疗的35例EMs患者,根据R-AFs分期标准将其分为Ⅰ~Ⅱ期15例和Ⅲ~Ⅳ期20例,根据月经周期分为增生期17例和分泌期18例。选择同期30例因卵巢、宫颈及输卵管部位疾病行腹腔镜手术治疗的非EMs患者为对照组。采用ELISA法检测VEGF、sVEGFR-1在各组患者血清及腹腔液中的表达水平,并比较VEGF活性指数。结果 EMs组患者血清及腹腔液VEGF、sVEGFR-1、VEGF活性指数均明显高于对照组(P<0.05),且Ⅲ~Ⅳ期高于Ⅰ~Ⅱ期患者(P<0.05)；对照组分泌期血清及腹腔液VEGF、sVEGFR-1表达水平均明显高于增生期患者( P<0.05),而EMs组患者不同月经周期比较差异无统计学意义(P>0.05),EMs组患者分泌期VEGF活性指数明显高于增生期(P<0.05),而与对照组比较差异无统计学意义(P>0.05)。结论 VEGF、sVEGFR1均参与了EMs的发生发展过程。%Objective To observe the expression of vascular endothelial growth factor ( VEGF) and soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) in serum, peritoneal fluid of patients with endometriosis (EMs), and to explore its clinical significance. Methods 35 patients with EMs who received laparoscopic surgery in Women and Children 's Health Care Hospital of Huangshi from Feb. 2013 to Aug. 2015 were selected, divided them into Ⅰ~Ⅱ period ( n=15 cases) and Ⅲ~Ⅳ period ( n=20 cases) according to R-AFs stage standard, and divided them into hyperplasia period ( n=17 cases) and secretion phase ( n=18 cases) according to the menstrual cycle. Selected 30 cases who received laparoscopic surgery with ovary, uterine neck or fallopian tube disease as control group. The expression of VEGF, sVEGFR-1 in serum, peritoneal fluid of these groups was detected by ELISA method, and compared the VEGF activity index. Results The VEGF, sVEGFR-1, VEGF activity index in serum and peritoneal fluid of EMs group were significantly higher than those of control group (P<0. 05), and Ⅲ~Ⅳ period was higher than that ofⅠ~Ⅱ period (P<0. 05). The expression levels of VEGF, sVEGFR-1 in serum and peritoneal fluid of secretion period of control group were significantly higher than those of hyperplasia period(P<0. 05), while there was no significant difference in different menstrual cycle in EMs group patients(P>0. 05), and the VEGF activity index of secretion period of EMs group was significantly higher than that of hyperplasia period(P<0. 05), and had no significant difference with control group(P>0. 05). Conclusion VEGF, sVEGFR-1 are involved in the development process of EMs.