Shen Fanghua, Wang Yuedong, Lu Yuan, Yuan Lei, Liu Xishi, Guo Sun-Wei
Department of Gynecology, Shanghai OB/GYN Hospital, and Department of Gynecology and Obstetrics, Fudan University, Shanghai Medical School, Shanghai, China.
Am J Obstet Gynecol. 2008 Nov;199(5):486.e1-486.e10. doi: 10.1016/j.ajog.2008.04.040. Epub 2008 Jun 13.
This study was undertaken to evaluate the immunoreactivity of progesterone receptor isoform B and nuclear factor kappa-B p65 subunit in ovarian endometrioma tissue samples harvested at the time of surgery and their relationship with the recurrence risk.
One hundred nine patients were selected; 53 of them had recurrence within 30 months after surgery, whereas the other 56 had not had recurrence at least 32 months after surgery. For each patient, host and clinical information was also collected. The patients' archived, formalin-fixed, paraffin-embedded tissue blocks were retrieved, subjected to immunohistochemical staining of progesterone receptor isoform B and nuclear factor kappa-B p65 subunit, and were scored and compared.
Increased nuclear factor kappa-B activation and decreased progesterone receptor isoform B immunoreactivity in ovarian endometriomas were 2 predominant factors in predicting recurrence. The classification tree method based on these 2 yielded a sensitivity of 86.6% and a specificity of 82.1%.
Nuclear factor kappa-B activation/p65 and progesterone receptor isoform B immunoreactivity in ovarian endometrioma jointly constitutes a good biomarker for recurrence. The close relationship between nuclear factor kappa-B activation/p65 subunit and progesterone receptor isoform B immunoreactivity strongly suggests their roles involved in recurrence and may thus be excellent therapeutic targets to prevent recurrence. Our finding supports the notion that there are identifiable molecular genetic differences intrinsic to ovarian endometriomas that confer recurrence risk differential.
本研究旨在评估手术时采集的卵巢子宫内膜异位囊肿组织样本中孕激素受体异构体B和核因子κB p65亚基的免疫反应性及其与复发风险的关系。
选取109例患者；其中53例在术后30个月内复发，而另外56例在术后至少32个月未复发。收集每位患者的宿主和临床信息。检索患者存档的福尔马林固定石蜡包埋组织块，进行孕激素受体异构体B和核因子κB p65亚基的免疫组化染色，并进行评分和比较。
卵巢子宫内膜异位囊肿中核因子κB激活增加和孕激素受体异构体B免疫反应性降低是预测复发的两个主要因素。基于这两个因素的分类树法敏感性为86.6%，特异性为82.1%。
卵巢子宫内膜异位囊肿中的核因子κB激活/p65和孕激素受体异构体B免疫反应性共同构成复发的良好生物标志物。核因子κB激活/p65亚基与孕激素受体异构体B免疫反应性之间的密切关系强烈表明它们在复发中的作用，因此可能是预防复发的理想治疗靶点。我们的研究结果支持这样一种观点，即卵巢子宫内膜异位囊肿存在可识别的内在分子遗传差异，这些差异导致复发风险不同。
