血清及腹腔液中VEGF、MMP-2、MMP-9水平在子宫内膜异位症中的诊断价值
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摘要
目的探讨检测血清及腹腔液中血管内皮生长因子(VEGF)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)水平对诊断子宫内膜异位症的价值。方法选取2016年2月一2017年11月于中国石油天然气集团公司中心医院妇产科经手术等检查证实为子宫内膜异位症的100例患者作为观察组,另选取同期治疗的100例非子宫内膜异位症患者作为对照组。分别检测2组患者血清及腹腔液中VEGF、MMP-2、MMP-9水平并进行比较。结果观察组患者血清中VEGF、MMP-2、MMP-9水平明显高于对照组(t=17.038、11.945、17.838,P均<0.01);观察组患者腹腔液中VEGF、MMP-2、MMP-9水平明显高于对照组(t=22.364、15.621、15.556,均<0.01)。观察组中,Ⅲ～Ⅳ期患者血清中VEGF、MMP-2、MMP-9水平明显高于Ⅰ～Ⅱ期(t=9.349、10.395、16.535,P均<0.01);Ⅲ～Ⅳ期患者腹腔液中VEGF、MMP-2、IMMP-9水平明显高于Ⅰ～Ⅱ期(t=9.772、13.853、13.347,P均<0.01)。血清中VEGF、MMP-2、MMP-9水平与子宫内膜异位症分期呈正相关性(r=0.975、0.768、0.761,P均<0.05);腹腔液中VEGF、MMP-2、MMP-9水平与子宫内膜异位症分期亦呈正相关性(r=0.911、0.772、0.767 P均<0.05)。结论检测子宫内膜异位症患者血清和腹腔液中VEGF、MMP-2、MMP-9水平可有助于诊断和评估患者病情,为临床治疗方案制定提供指导价值。
Objective To investigate the significance of detecting serum levels of vascular endothelial growth factor(VEGF), matrix metalloproteinase 2(MMP-2) and matrix metalloproteinase 9( MMP-9) in the diagnosis of endometriosis.Methods Selected in our hospital after surgery and other tests confirmed 100 cases of endometriosis as the study observation group, the other selected the same period in our hospital for treatment of 100 cases of non-endometriosis patients as the study control group. The levels of VEGF, MMP-2 and MMP-9 in serum and peritoneal fluid of the two groups were detected. Results The serum levels of VEGF, MMP-2 and MMP-9 in the observation group were(236. 5 ±59. 8) ng/L,(195. 8 ±52. 2) μg/L,(232. 5 ±43. 8) μg/L, which were significantly higher than those in the control group(118. 7 ±34. 7) ng/L,( 124.7 ±28.6) μ/L,(138.7 ±29.1)μg/L(t= 17.038,t= 11.945, t= 17.838, P<0.01); VEGF,MMP2, MMP9 in the peritoneal fluid of the observation group were(861.2 ±258. 7) ng/L,(44. 9 ± 14. 1) μg/L, and(55. 1 ±18.8) μg/L, respectively,which were significantly higher than those of the control group(269. 8 ±54. 8) μg/L,(18. 6). ± 9. 2) μg/L,(24.0 ± 6. 8) μg/L(t = 22. 364,t= 15. 621,t= 15. 556,P<0. 01). In the observation group,the serum levels of VEGF,MMP-2, and MMP-9 were significantly higher in stage Ⅲ,Ⅳ patients than in stage Ⅰ, Ⅱ(t =9. 349, t = 10. 395, t= 16.535, P <0.05); in the observation group, stage Ⅲ,Ⅳ's VEGF, MMP-2, and MMP-9 in patients' peritoneal fluid were significantly higher than those in stage I to II(t =9. 772, t=13. 853, t=13. 347, P < 0. 05). Conclusion Detection of VEGF, MMP-2, MMP-9 levels in serum and peritoneal fluid of patients with endometriosis can help clinicians to diagnose and assess the patients condition, and provide guidance value for the development of clinical treatment plan.
Objective To investigate the significance of detecting serum levels of vascular endothelial growth factor(VEGF), matrix metalloproteinase 2(MMP-2) and matrix metalloproteinase 9( MMP-9) in the diagnosis of endometriosis.Methods Selected in our hospital after surgery and other tests confirmed 100 cases of endometriosis as the study observation group, the other selected the same period in our hospital for treatment of 100 cases of non-endometriosis patients as the study control group. The levels of VEGF, MMP-2 and MMP-9 in serum and peritoneal fluid of the two groups were detected. Results The serum levels of VEGF, MMP-2 and MMP-9 in the observation group were(236. 5 ±59. 8) ng/L,(195. 8 ±52. 2) μg/L,(232. 5 ±43. 8) μg/L, which were significantly higher than those in the control group(118. 7 ±34. 7) ng/L,( 124.7 ±28.6) μ/L,(138.7 ±29.1)μg/L(t= 17.038,t= 11.945, t= 17.838, P<0.01); VEGF,MMP2, MMP9 in the peritoneal fluid of the observation group were(861.2 ±258. 7) ng/L,(44. 9 ± 14. 1) μg/L, and(55. 1 ±18.8) μg/L, respectively,which were significantly higher than those of the control group(269. 8 ±54. 8) μg/L,(18. 6). ± 9. 2) μg/L,(24.0 ± 6. 8) μg/L(t = 22. 364,t= 15. 621,t= 15. 556,P<0. 01). In the observation group,the serum levels of VEGF,MMP-2, and MMP-9 were significantly higher in stage Ⅲ,Ⅳ patients than in stage Ⅰ, Ⅱ(t =9. 349, t = 10. 395, t= 16.535, P <0.05); in the observation group, stage Ⅲ,Ⅳ's VEGF, MMP-2, and MMP-9 in patients' peritoneal fluid were significantly higher than those in stage I to II(t =9. 772, t=13. 853, t=13. 347, P < 0. 05). Conclusion Detection of VEGF, MMP-2, MMP-9 levels in serum and peritoneal fluid of patients with endometriosis can help clinicians to diagnose and assess the patients condition, and provide guidance value for the development of clinical treatment plan.
引文
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[3]周青平,罗红艳,司马妮.子宫内膜异位症患者血清糖类抗原125、血管内皮生长因子和胰岛素样生长因子-1的表达及意义[J].中国妇幼保健,2017,32(9):1841-1844.DOI:10.7620/zgfybj.j.issn.1001-4411.2017.09.05.
[4]温丽,郭珍,常春红,等.子宫内膜异位症患者血清和腹腔液中VEGF、IL-6、TNF-α、CA125表达及临床意义[J].现代中西医结合杂志,2017,26(5):467470.D01:10.3969/j.issn.1008-8849.2017.05.004.
[5]杨琴,吴海波,张艳琴,等.基质金属蛋白酶-2在子宫内膜异位症中的表达及应用价值[J].现代生物医学进展,2016,16(32):6322-6325.DOI:10.13241/j.cnki.pmb.2016.32.030.
[6]张星光,马建婷,傅家欣,等.β-catenin、VEGF及MMP-9在子宫内膜异位症中的表达及意义[J].健康研究,2016,36(5):530-532.DOI:10.3969/j.issn.1674-6449.2016.05.016.
[7]白治苗,姚卫卫,李望舒,等.骨桥蛋白在子宫内膜异位症中介导细胞迁移与依赖核转录因子κB通路促进基质金属蛋白酶及尿激酶型纤溶酶原激活物表达中的作用研究[J].中国全科医学,2016,19(24):2930-2934.DOI:10.3969/j.issn.1007-9572.2016.24.012.
[8]吕红青,邵明君,胡美旭,等.米非司酮对行腹腔镜子宫内膜异位手术患者性激素及细胞因子的影响[J].中国临床药理学与治疗学,2018,(2):180-183.DOI:10.12092/j.issn.1009-2501.2018.02.012.
[9]周先韦,盛少琴,胡凤英.垂体后叶素在腹腔镜下卵巢子宫内膜异位囊肿剔除术中的应用[J].中国临床药理学与治疗学,2018,(1):88-92.DOI:10.12092/j.issn.1009-2501.2018.01.017.
[10]赵红伟.雌激素受体β在子宫内膜异位症中的作用及意义[J].疑难病杂志,2018,17(3):315-318.D01:10.3969/j.issn.1671-6450.2018.03.025.
[11]黄燕清,管玉涛,伍嘉宝,等.子宫内膜异位症盆腔粘连程度与腹腔液中基质金属蛋白酶水平的关系[J].中国妇幼保健,2016,31(9):1806-1809.DOI:10.7620/zgfybj.j.issn.1001-4411.2016.09.05.
[12]张敏,宋殿荣,曹保利,等.SDF-1、CXCR4、MMP-9及VEGF在子宫内膜异位症组织中的表达及意义[J].现代中西医结合杂志,2016,25(11):1147-1150.DOI:10.3969/j.issn.1008-8849.2016.11.002.
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[16]黄丽霞,马利国,蔡如玉,等.子宫内膜异位症患者在位内膜的MMP-9和VEGF的表达[J].海南医学,2015,26(23):3478-3480.DOI:10.3969/j.issn.1003-6350.2015.23.1260.
[17]冯晓冰.组织基质金属蛋白酶、细胞间黏附分子-1表达与子宫内膜异位症的相关性研究[J].中国妇幼保健,2015,30(8):1259-1260.DOI:10.7620/zgfybj.j.issn.1001-4411.2015.08.40.
[18]吕雁,刘红英,游兰,等.卵巢子宫内膜异位囊肿在腹腔镜术前应用GnRH-a的临床疗效分析[J].疑难病杂志,2017,16(7):702-705.DOI:10.3969/j.issn.1671-6450.2017.07.014.
[19]王菲菲,龚晔晟.张洁琼.子宫内膜异位症患者血清和腹腔液中VEGF、IL-6、IL-8的表达情况及临床意义[J].北京医学,2015,37(2):138-141.DOI:10.15932/j.0253-9713.2015.2.011.