Yang Shun-Fa, Wu Tzu-Fan, Tsai Hsiu-Ting, Lin Long-Yau, Wang Po-Hui
Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan.
Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan.
Clin Chim Acta. 2014 Apr 20;431:118-24. doi: 10.1016/j.cca.2014.02.004. Epub 2014 Feb 11.
Pelvic inflammatory disease (PID) is a common infection in women of reproductive age. However, diagnosis of PID can be difficult due to the wide variation in the symptoms and signs, ranging from subtle or mild symptoms to severe pain in the lower abdomen. Clinical diagnosis alone has only 87% sensitivity and 50% specificity. Therefore, identifying biological factors that are useful for early diagnosis and correlating their expression with the severity of PID could provide significant benefits to women suffering from PID. Pentraxin 3 (PTX3), E-cadherin, myeloperoxidase, stromal cell-derived factor 1 (SDF-1) and the matrix metalloproteinase-9 (MMP-9)/MMP-2 ratio are potential candidates for detecting PID reliably. As PID is often subtle, highly sensitive PID detection methods are needed to promote the prevention of severe sequelae. Growth arrest-specific 6 (Gas6), in combination with its soluble tyrosine kinase receptor, sAxl, could elevate the sensitivity to 92%, which was higher than all other markers tested. Moreover, PTX3, D-dimer and YKL-40 concentrations can predict the clinical course of PID. Although single nucleotide polymorphisms of biomarker genes are not associated with the development of PID, myeloperoxidase SNP -463 G/A and SDF-1 SNP 801 G/A may affect the aggravated expression of their biomarkers in PID.
盆腔炎（PID）是育龄期女性的常见感染性疾病。然而，由于症状和体征差异很大，从轻微或不明显的症状到下腹部剧痛，PID的诊断可能存在困难。仅依靠临床诊断，敏感性仅为87%，特异性为50%。因此，确定有助于早期诊断的生物学因素，并将其表达与PID的严重程度相关联，可能会给患有PID的女性带来显著益处。五聚素3（PTX3）、E-钙黏蛋白、髓过氧化物酶、基质细胞衍生因子1（SDF-1）以及基质金属蛋白酶-9（MMP-9）/MMP-2比值是可靠检测PID的潜在候选指标。由于PID通常不明显，因此需要高灵敏度的PID检测方法来预防严重后遗症。生长停滞特异性蛋白6（Gas6）与其可溶性酪氨酸激酶受体sAxl结合，可将检测灵敏度提高到92%，高于所有其他检测的标志物。此外，PTX3、D-二聚体和YKL-40的浓度可以预测PID的临床病程。虽然生物标志物基因的单核苷酸多态性与PID的发生无关，但髓过氧化物酶SNP -463 G/A和SDF-1 SNP 801 G/A可能会影响其在PID中的生物标志物的加重表达。
