子宫内膜异位症患者内膜组织中 kiss-1 及血清和腹腔液中 sflt-1、VEGF、MCP-1、RANTES 表达的意义

摘要

目的 研究子宫内膜异位症患者内膜组织中kiss-1及血清和腹腔液中血管内皮生长因子可溶性受体(sflt-1)、血管内皮生长因子(VEGF)、单核细胞趋化蛋白-1(MCP-1)、T细胞表达和分泌的调节性激活因子( RANTES)表达的意义. 方法 选取子宫内膜异位症行腹腔镜手术患者256例作为观察组,根据病变部位、大小、粘连程度分为Ⅰ~Ⅱ期组76例,Ⅲ~Ⅳ期组180例. 选取同期因卵巢良性肿瘤、卵巢系膜囊肿、宫颈病变等入院治疗的患者114例作为对照组. 采用免疫组化法测定受检者子宫内膜组织标本kiss-1的表达情况,采用ELISA方法测定受检者血清和腹腔液中sflt-1、VEGF、MCP-1、RANTES表达情况. 结果 观察组kiss-1阳性表达率明显低于对照组( P＜0.05 ). Ⅰ~Ⅱ期组kiss-1阳性表达率明显高于Ⅲ~Ⅳ期组(P＜0.05). 观察组血清和腹腔液中sflt-1、VEGF、MCP-1、RANTES表达水平明显高于对照组(P均＜0.05). Ⅰ~Ⅱ期组血清和腹腔液中 sflt-1、VEGF和RANTES表达水平低于Ⅲ~Ⅳ期组(P＜0.05). 结论kiss-1、sflt-1、VEGF、MCP-1、RANTES水平与子宫内膜异位症发展密切相关,可能参与了其发病过程,可以作为子宫内膜异位症的辅助检测指标.%Objectiv eIt is to study the significance of the expression of kiss -1 in endomentrial tissue and the expression of sflt-1, VEGF, MCP-1, RANTES in serum and peritoneal fluid in the patients with endometriois .Mtehods 256 cases of patients with endometriosis undergoing laparoscopic surgery were selected as observation group , in which according to the le-sion, the size of adhesions there were 76 cases of stage Ⅰ-Ⅱ(Ⅰ-Ⅱstage group),Ⅲ-Ⅳof 180 cases (Ⅲ-Ⅳstage group).114 cases of patients admitting to hospital because of ovarian tumor , mesosalpinx cyst, cervical lesions were selected as control group .The expression of kiss -1 endomentrial tissue was detected by immunohistochemistry , and the expression of sflt-1, VEGF, MCP-1, RANTES in serum and peritoneal fluid were detected by ELISA .Results The positive rate of the expression of kiss -1 in observation group was significantly lower than that in the control group (P＜0.05), and the rate inⅠ-Ⅱstage group was significantly higher than that in Ⅲ-Ⅳstage group(P all＜0.05).The levels of the expression of sflt -1, VEGF, MCP-1, RANTES in serum and peritoneal fluid were significantly higher than those in the control group ( P＜0.05) . The levels in Ⅰ-Ⅱstage group were significantly lower than those in Ⅲ-Ⅳ stage group (P all＜0 .05 ) .Conc lusion The levels of kiss-1, sflt-1, VEGF, MCP-1, RANTES are closely related with the development of endometriosis , which may be involved in its pathogenesis , and can be used as auxiliary determing indexes of endometriosis .