子宫内膜异位症患者血清、腹腔液、在位/异位内膜组织中RANTES的表达及意义

摘要

目的 研究子宫内膜异位症(Ems)患者血清、腹腔液、在位/异位内膜组织中RANTES的表达及意义.方法 采用酶联免疫吸附(ELISA)法测定研究组(经腹腔镜确诊为盆腔Ems的育龄期妇女,30例)及对照组(因盆腔良性肿瘤行腹腔镜手术、且盆腔结构正常妇女,19例)的血清、腹腔液、在位内膜及异位内膜组织中RANTES的表达,并分析RANTES水平与手术RAS评分、痛经程度的关系.结果 血清中RANTES水平:研究组及对照组差异无统计学意义(P=0.350),与手术RAS评分、痛经程度之间无相关性;腹腔液中RANTES水平:研究组与对照组差异有统计学意义(P=0.041),研究组Ⅰ-Ⅱ期与Ⅲ-Ⅳ期差异有统计学意义(P=0.001),与手术RAS评分呈正相关(r=0.764、P=0.000),但与痛经程度无相关性.异位内膜组(n=16)与正常内膜组(n=13)、在位内膜组(n=22)与正常内膜组、异位内膜组与在位内膜组之间RANTES水平差异有统计学意义(P=0.000、P=0.000、P=0.005),在位内膜组、异位内膜组Ⅰ-Ⅱ期与Ⅲ-Ⅳ期RANTES水平差异有统计学意义(P=0.008、P=0.018);异位内膜组和在位内膜组RANTES水平与手术RAS评分呈正相关(r=0.745、P=0.005,r=0.515、P=0.034),但与痛经程度均无相关性.结论 RANTES在Ems患者腹腔液、异位内膜、在位内膜中表达明显增强,且与手术RAS评分呈正相关,与痛经程度无相关性,推测RANTES参与了Ems的发生、发展过程.%Objective To explore the expression of RANTES in serum ,peritoneal fluid and ec-topic/eutopic endometrium and its clinical significance in women with endometriosis .Methods The expression of RANTES in serum ,peritoneal fluid and ectopic/eutopic endometrium was detected by ELISA in 30 women of childbearing age who were diagnosed as having pelvic endometri -osis by laparoscopy (experimental group ) and 19 women with normal pelvic structure who underwent laparoscopic surgery for benign pelvic masses (control group).The relationships of RANTES levels to RAS scores and dysmenorrheal degree were analyzed .Results There were no significant differences in serum RANTES levels between control group and experimental group (P= 0.350),and serum RANTES levels were not correlated with RAS scores and dysmenorrheal degree .The differences in peritoneal fluid levels of RANTES were significant between experimental group and control group (P=0 .041 ) ,as well as between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ in experimental group .RANTES levels in peritoneal fluid were positively correlated with RAS scores (r-0 .764 , P= 0 .000 ) ,but were not correlated with dysmenorrheal degree in experimental group . Furthermore ,the levels of RANTES were significantly different between ectopic endometrium (n-16) and normal endometrium (n=13),as well as between eutopic endometrium (n=22) and normal endometrium and between ectopic endometrium and eutopic endometrium ( P=0 .000 ,P= 0 .000 and P=0 .005 respectively ) .There was a positive correlation in RANTES levels between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ in eutopic endometrium and ectopic endometrium ( P= 0 .008 and P=0 .018 respectively ) .Moreover , RANTES levels in ectopic endometrium and eutopic endometrium were positively correlated with RAS scores (r=0 .745 ,P=0 .005 and r=0 .515 ,P=0 .034 , respectively ) ,but were not correlated with dysmenorrheal degree .Conclusion The expression of RANTES significantly increases in peritoneal fluid and eutopic/ectopic endometrium from patients with endometriosis ,and are positively correlated with RAS scores ,but are not correlated with dysmenorrheal degree, suggesting that RANTES plays a important role in the occurrence and development of endometriosis .