摘要
目的 探究卵巢型子宫内膜异位症(EMs)患者外周血氧自由基(ROS)、氧磷酶-1(PON-1)水平和miR-20a表达水平及与病情的关系.方法 回顾性选取2020年3月至2023年3月在江苏省人民医院(南京医科大学第一附属医院)进行治疗的113例卵巢型EMs患者纳入研究组,并根据美国生育协会分期标准对其进行分组:62例Ⅰ～Ⅱ期患者纳入轻度组,51例Ⅲ～Ⅳ期患者纳入重度组.另选30例在本院进行治疗的盆腔炎且子宫内膜正常患者纳入对照组.比较研究组与对照组患者、轻度组与重度组患者的ROS、PON-1水平和miR-20a相对表达水平,比较轻度组与重度组的血清炎症因子[白细胞介素(IL)-6、IL-8、单核细胞趋化蛋白-1(MCP-1)、肿瘤坏死因子-α(TNF-α)]水平,并探究其与患者病情严重程度的相关性,采用受试者工作特征(ROC)曲线分析ROS、PON-1水平和miR-20a表达水平对重度卵巢型EMs的诊断价值.结果 研究组患者的ROS水平和miR-20a相对表达水平分别为(485.55±32.12)pg/mL、2.48±0.33,均高于对照组患者[(326.26±28.12)pg/mL、1.03±0.24],PON-1 水平为(152.23±8.78)pg/mL,低于对照组患者[(212.26±8.23)pg/mL],差异均有统计学意义(P＜0.05).重度组患者的ROS水平和miR-20a相对表达水平分别为(498.22±18.45)pg/mL、2.64±0.37,均高于轻度组患者[(433.28±23.16)pg/mL、1.97±0.21],PON-1水平为(142.04±5.99)pg/mL,低于轻度组患者[(164.56±5.48)pg/mL],差异均有统计学意义(P＜0.05).重度组患者的血清 IL-6、IL-8、MCP-1、TNF-α 水平分别为(33.26±2.45)、(29.55±3.16)、(39.45±2.78)、(29.88 ±2.64)pg/mL,均高于轻度组患者[(17.22±2.23)、(23.66±3.15)、(32.45±2.54)、(21.02±2.37)pg/mL],差异均有统计学意义(P＜0.05).ROS水平,miR-20a相对表达水平,IL-6、IL-8、MCP-1、TNF-α水平与患者的临床分期呈正相关(r=0.847、0.751、0.862、0.685、0.830、0.859,P＜0.05),PON-1 水平与患者的临床分期呈负相关(r=-0.856,P＜0.05).ROS、PON-1水平,miR-20a相对表达水平诊断重度卵巢型子宫内膜异位的ROC曲线的曲线下面积(AUC)分别为0.991、0.997、0.936,具有较好诊断价值(P＜0.05)6结论 ROS水平、miR-20a相对表达水平在卵巢型EMs患者中升高,PON-1水平表达下调,且对其病情严重程度具有一定诊断价值,可用于临床辅助诊断.
Abstract
Objective To explore the levels of reactive oxygen species(ROS),oxyphosphonase-1(PON-1)and miR-20a expres-sion in peripheral blood of patients with ovarian endometriosis(EMs)and their relationship with the disease.Methods A total of 113 patients with ovarian EMs treated in Jiangsu Provincial Hospital(The First Affiliated Hospital of Nanjing Medical University)from March 2020 to March 2023 were selected to be included in the study group,and grouped according to the staging criteria of the American Fertility Society:62 patients with stage Ⅰ to Ⅱ were included in the mild group,51 patients with stage Ⅲ to Ⅳ were included in the severe group,and another 30 patients with pelvic inflammatory disease and normal endometrium treated in our hospital were included in the control group.The levels of ROS,PON-1,and miR-20a relative expression were compared between the study group and the control group,as well as between the mild group and the severe group of patients.The levels of serum inflammatory factors[interleukin(IL)-6,IL-8,monocyte chemoattractant protein-1(MCP-1),tumor necrosis factor-alpha(TNF-α)]were compared between the mild group and the severe group of patients,the correlation the disease severity was also explored.The diagnostic value of ROS,PON-1 levels,and miR-20a expression in severe ovarian EMs was analyzed using receiver operat-ing characteristic(ROC)curves.Results The levels of ROS and miR-20a relative expression in the study group patients were(485.55±32.12)pg/mL and 2.48±0.33,respectively,which were higher than those in the control group[(326.26±28.12)pg/mL and 1.03±0.24],the lev-el of PON-1 was(152.23±8.78)pg/mL,which was lower than that in the control group[212.26±8.23)pg/mL],and the differences were statistically significant(P＜0.05).The levels of ROS and miR-20a relative expression in the severe group were(498.22±18.45)pg/mL and 2.64±0.37,respectively,which were higher than those in the mild group[(433.28±23.16)pg/mL and 1.97±0.21],and the level of PON-1 was(142.04±5.99)pg/mL,which was lower than that in the mild group[(164.56±5.48)pg/mL],and the differences were statistically significant(P＜0.05).The levels of serum IL-6,IL-8,MCP-1,TNF-α in the severe group were(33.26±2.45),(29.55±3.16),(39.45±2.78),(29.88±2.64)pg/mL,respectively,which were higher than those in the mild group[(17.22±2.23),(23.66±3.15),(32.45±2.54),(21.02±2.37)pg/mL],and the differences were statistically significant(P＜0.05).The levels of ROS,miR-20a rela-tive expression,IL-6,IL-8,MCP-1,and TNF-α were positively correlated with the clinical stage of patients(r=0.847,0.751,0.862,0.685,0.830,0.859,P＜0.05),while the level of PON-1 was negatively correlated with the clinical stage of patients(r=-0.856,P＜0.05).The area under the curve(AUC)of the ROC curve for diagnosing severe ovarian EMs with ROS,PON-1 levels,and miR-20a relative expression level were 0.991,0.997,and 0.936,respectively,indicating good diagnostic value(P＜0.05).Conclusion The ROS level and miR-20a relative expression level were increased in patients with ovarian EMs,while the PON-1 level was decreased,which had certain diag-nostic value for the severity of the disease,and could be used for clinical auxiliary diagnosis.
基金项目
江苏省卫生健康委医学科研项目(ZDB2020031)
维普
万方数据