Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Gangnam-gu, Seoul 135-720, Korea.
Hum Reprod. 2012 Feb;27(2):515-22. doi: 10.1093/humrep/der345. Epub 2011 Dec 8.
Recently, proteomic technologies have demonstrated that several proteins are differently expressed in various body fluids of patients with endometriosis compared with those without this condition. The aim of this study was to investigate proteins secreted in urine of patients with endometriosis using proteomic techniques in order to identify potential markers for the clinical diagnosis of endometriosis.
Urine samples were collected from women undergoing laparoscopy for different indications including pelvic masses, pelvic pain, suspicious endometriosis, infertility and diagnostic evaluation. Proteomic techniques and mass spectrometry were used to identify proteins secreted in the urine of the patients with and without endometriosis and quantification of identified protein was performed using western blot and specific commercial sandwich enzyme-linked immunosorbent assays (ELISA).
Twenty-two protein spots were differentially expressed in the urine of patients with and without endometriosis, one of which was identified as urinary vitamin D-binding protein (VDBP). ELISA quantification of urinary VDBP corrected for creatinine expression (VDBP-Cr) revealed that urinary VDBP-Cr was significantly greater in patients with endometriosis than in those without (111.96 ± 74.59 versus 69.90 ± 43.76 ng/mg Cr, P = 0.001). VDBP-Cr had limited value as a diagnostic marker for endometriosis (Sensitivity 58%, Specificity 76%). When combined with serum CA-125 levels (the product of serum CA-125 and urinary VDBP-Cr), it did not significantly increase the diagnostic power of serum CA-125 alone.
Urinary VDBP levels are elevated in patients with endometriosis. They have limited value as a potential diagnostic biomarker for endometriosis but suggest it would be worthwhile to investigate other urinary proteins for this purpose.
最近，蛋白质组学技术表明，与没有子宫内膜异位症的患者相比，患有子宫内膜异位症的患者在不同体液中存在几种差异表达的蛋白质。本研究旨在使用蛋白质组学技术检测子宫内膜异位症患者尿液中分泌的蛋白质，以鉴定用于子宫内膜异位症临床诊断的潜在标志物。
收集因不同原因（包括盆腔肿块、盆腔疼痛、疑似子宫内膜异位症、不孕和诊断评估）而接受腹腔镜检查的女性的尿液样本。使用蛋白质组学技术和质谱鉴定有无子宫内膜异位症患者尿液中分泌的蛋白质，并使用 Western blot 和特定的商业夹心酶联免疫吸附测定（ELISA）对鉴定出的蛋白质进行定量。
在有无子宫内膜异位症患者的尿液中，有 22 个蛋白质斑点表达差异，其中一个被鉴定为尿维生素 D 结合蛋白（VDBP）。用肌酐表达校正的尿 VDBP 定量（VDBP-Cr）显示，患有子宫内膜异位症的患者尿 VDBP-Cr 明显高于无子宫内膜异位症的患者（111.96±74.59 与 69.90±43.76ng/mg Cr，P=0.001）。VDBP-Cr 作为子宫内膜异位症的诊断标志物的价值有限（敏感性 58%，特异性 76%）。当与血清 CA-125 水平（血清 CA-125 与尿 VDBP-Cr 的乘积）联合使用时，并未显著增加血清 CA-125 单独使用的诊断能力。
子宫内膜异位症患者的尿 VDBP 水平升高。它们作为子宫内膜异位症潜在诊断生物标志物的价值有限，但表明有必要为此目的研究其他尿液蛋白质。
