VEGF、MMP-9、Galectin-3在卵巢子宫内膜异位症发病中的作用及临床应用价值(1)
【摘要】 目的：探讨 血清血管内皮生长因子(vascular endothelial growth factor，VEGF)、半乳糖凝集素-3(Galectin-3)、基质金属蛋白酶-9(matrix metalloproteinase-9，MMP-9)在卵巢子宫内膜异位症(endometriosis，EMs)中的表达及临床应用价值。方法：选取卵巢子宫内膜异位症患者32例为EMs组，妇科良性疾病且排除EMs患者40例为对照组。采用酶联免疫吸附试验技术检测EMs组与对照组患者术前血清中VEGF、Galectin-3、MMP-9的表达情况，采用ROC曲线分析三因子在卵巢EMs诊断中的临床应用价值。结果：EMs组血清中VEGF、Galectin-3及MMP-9的表达水平均高于对照组(P<0.05)。EMs组血清中VEGF、Galectin-3及MMP-9在Ⅲ、Ⅳ期患者中的表达水平均高于Ⅰ、Ⅱ期患者(P<0.05)。ROC曲线分析显示，VEGF、Galectin-3、MMP-9在EMs中诊断的灵敏度分别为75.0%、84.4%、75.0%，特異度分别为70.0%、52.5%、77.5%。结论：血清VEGF、Galectin-3、MMP-9可能与EMs的发生、发展有关，检测血清中VEGF、Galectin-3、MMP-9的表达水平对卵巢EMs早期诊断、病情评估及随访有临床应用价值。
【关键词】 血管内皮生长因子 半乳糖凝集素-3 基质金属蛋白酶-9 子宫内膜异位症 酶联免疫吸附试验
[Abstract] Objective： To investigate the value of serum vascular endothelial growth factor (VEGF)， Galectin-3， matrix metalloproteinase-9 (MMP-9) in the diagnosis for patients with ovarian endometriosis (EMs). Method： 32 patients diagnosed as ovarian endometriosis were defined as EMs group， 40 patients diagnosed as gynecological benign disease and excluded EMs were defined as control group. The levels of serum VEGF， Galectin-3， MMP-9 were determined by enzyme-linked immunosorbent assay (ELISA) for EMs group and control group. The receiver operating characteristics (ROC) curve analysis was performed to analyze the value of VEGF， Galectin-3 and MMP-9 in the diagnosis of EMs. Result： The levels of serum VEGF， MMP-9 and Galectin-3 in EMs group were signincantly higher than those in control group (P<0.05). The levels of serum VEGF， MMP-9 and Galectin-3 in patients with stage Ⅲ and Ⅳ in EMs group were significantly higher than those in patients with stageⅠ， Ⅱ (P<0.05). The results of ROC curve analysis showed that the diagnostic sensitivity and specificity of VEGF， Galectin-3， MMP-9 were 75.0%， 84.4%， 75.0% and 70.0%， 52.5%， 77.5%， respectively. Conclusion： VEGF， Galectin-3 and MMP-9 likely to be the pathogenesis of EMs， the detection of serum VEGF， Galectin-3 and MMP-9 can be used as indicators for early diagnosis， assessment and follow-up of EMs.
[Key words] Vascular endothelial growth factor Galectin-3 Matrix metalloproteinase-9 Endometriosis ELISA
First-author’s address： The Third Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China
doi：10.3969/j.issn.1674-4985.2019.35.027
子宫内膜异位症(endometriosis，EMs)是指子宫内膜组织在子宫以外的部位出现、生长、浸润，反复出血，发生病变，继而引发疼痛、不孕及包块等[1]，多见于育龄期妇女。EMs虽然是良性疾病，但其行为学上有类似恶性肿瘤的特点，如种植、侵袭、远处转移和易复发等特点[2]。EMs的预后与病情的进展程度有关，因此早诊断、早治疗有助于提高患者的疗效及改善生育能力。EMs的病变发生首先需要内膜细胞异位至盆腹腔相应部位，其次通过黏附与侵袭作用在该部位形成病灶，同时生成血管使异位病灶能够长期存在与发展，此过程需要多种细胞因子及相关信号通路参与其中。血管内皮生长因子(vascular endothelial growth factor，VEGF)主要起促进血管生成的作用，有利于异位病灶的血管生成，可能加重EMs病情的进展[3]。半乳糖凝集素-3(Galectin-3)属于半乳糖凝集素家族，其作用广泛，参与体内多种生理过程，尤其是细胞的增殖和凋亡方面，并在肿瘤的侵袭与转移中发挥重要作用[4]，但在具有侵袭、转移特性的卵巢EMs中研究较少，有学者经试验研究发现Galectin-3在EMs患者异位及在位内膜中的表达高于非EMs患者的在位内膜[5]，然而缺乏其在EMs血清中表达的研究。基质金属蛋白酶-9(matrix metalloproteinase-9，MMP-9)属于基质金属蛋白酶家族，可降解细胞外基质及基底膜，可能有利于异位病灶的发展，近年来较多研究发现MMP-9与EMs的发生、进展有关[6]。本研究主要通过检测血清VEGF、Galectin-3、MMP-9在卵巢EMs中的表达并探讨分析其在卵巢EMs的诊断、分期中的意义。现报道如下。, http://www.100md.com(李灿宇 王婷婷 刘欢欢 王宝金 申爱荣 封全灵)
【关键词】 血管内皮生长因子 半乳糖凝集素-3 基质金属蛋白酶-9 子宫内膜异位症 酶联免疫吸附试验
[Abstract] Objective： To investigate the value of serum vascular endothelial growth factor (VEGF)， Galectin-3， matrix metalloproteinase-9 (MMP-9) in the diagnosis for patients with ovarian endometriosis (EMs). Method： 32 patients diagnosed as ovarian endometriosis were defined as EMs group， 40 patients diagnosed as gynecological benign disease and excluded EMs were defined as control group. The levels of serum VEGF， Galectin-3， MMP-9 were determined by enzyme-linked immunosorbent assay (ELISA) for EMs group and control group. The receiver operating characteristics (ROC) curve analysis was performed to analyze the value of VEGF， Galectin-3 and MMP-9 in the diagnosis of EMs. Result： The levels of serum VEGF， MMP-9 and Galectin-3 in EMs group were signincantly higher than those in control group (P<0.05). The levels of serum VEGF， MMP-9 and Galectin-3 in patients with stage Ⅲ and Ⅳ in EMs group were significantly higher than those in patients with stageⅠ， Ⅱ (P<0.05). The results of ROC curve analysis showed that the diagnostic sensitivity and specificity of VEGF， Galectin-3， MMP-9 were 75.0%， 84.4%， 75.0% and 70.0%， 52.5%， 77.5%， respectively. Conclusion： VEGF， Galectin-3 and MMP-9 likely to be the pathogenesis of EMs， the detection of serum VEGF， Galectin-3 and MMP-9 can be used as indicators for early diagnosis， assessment and follow-up of EMs.
[Key words] Vascular endothelial growth factor Galectin-3 Matrix metalloproteinase-9 Endometriosis ELISA
First-author’s address： The Third Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China
doi：10.3969/j.issn.1674-4985.2019.35.027
子宫内膜异位症(endometriosis，EMs)是指子宫内膜组织在子宫以外的部位出现、生长、浸润，反复出血，发生病变，继而引发疼痛、不孕及包块等[1]，多见于育龄期妇女。EMs虽然是良性疾病，但其行为学上有类似恶性肿瘤的特点，如种植、侵袭、远处转移和易复发等特点[2]。EMs的预后与病情的进展程度有关，因此早诊断、早治疗有助于提高患者的疗效及改善生育能力。EMs的病变发生首先需要内膜细胞异位至盆腹腔相应部位，其次通过黏附与侵袭作用在该部位形成病灶，同时生成血管使异位病灶能够长期存在与发展，此过程需要多种细胞因子及相关信号通路参与其中。血管内皮生长因子(vascular endothelial growth factor，VEGF)主要起促进血管生成的作用，有利于异位病灶的血管生成，可能加重EMs病情的进展[3]。半乳糖凝集素-3(Galectin-3)属于半乳糖凝集素家族，其作用广泛，参与体内多种生理过程，尤其是细胞的增殖和凋亡方面，并在肿瘤的侵袭与转移中发挥重要作用[4]，但在具有侵袭、转移特性的卵巢EMs中研究较少，有学者经试验研究发现Galectin-3在EMs患者异位及在位内膜中的表达高于非EMs患者的在位内膜[5]，然而缺乏其在EMs血清中表达的研究。基质金属蛋白酶-9(matrix metalloproteinase-9，MMP-9)属于基质金属蛋白酶家族，可降解细胞外基质及基底膜，可能有利于异位病灶的发展，近年来较多研究发现MMP-9与EMs的发生、进展有关[6]。本研究主要通过检测血清VEGF、Galectin-3、MMP-9在卵巢EMs中的表达并探讨分析其在卵巢EMs的诊断、分期中的意义。现报道如下。, http://www.100md.com(李灿宇 王婷婷 刘欢欢 王宝金 申爱荣 封全灵)