特定卵巢病变患者血清及腹腔液中可溶性人类白细胞抗原、肿瘤坏死因子α及白细胞介素10的浓度
Serum and peritoneal fluid concentrations of soluble human leukocyte antigen, tumor necrosis factor alpha and interleukin 10 in patients with selected ovarian pathologies.
作者信息
Sipak-Szmigiel Olimpia, Włodarski Piotr, Ronin-Walknowska Elżbieta, Niedzielski Andrzej, Karakiewicz Beata, Słuczanowska-Głąbowska Sylwia, Laszczyńska Maria, Malinowski Witold
机构信息
Department of Obstetrical and Gynecological Nursing, Pomeranian Medical University, 48 Żołnierska, 71-210, Szczecin, Poland.
Clinical Hospital SPS ZOZ "Zdroje", Mączna 4, 70-780, Szczecin, Poland.
出版信息
J Ovarian Res. 2017 Apr 4;10(1):25. doi: 10.1186/s13048-017-0320-9.
BACKGROUND
Although immune system plays a key role in the pathogenesis of both endometriosis and ovarian cancer, its function is different. Therefore, we hypothesized, that selected immune parameters can serve as diagnostic markers of these two conditions. The aim of this study was to compare serum and peritoneal fluid concentrations of sHLA-G, IL-10 and TNF-alpha in women with selected ovarian pathologies: benign serous cysts, endometrioma and malignant tumors. Clinical significance of using them for diagnostic purposes in women with serous ovarian cysts, endometriosis, and ovarian cancer, which in the future may improve the early diagnosis of ovarian diseases.
CASE PRESENTATION
The study included women treated surgically for benign serous ovarian cysts, ovarian endometrioma and serous ovarian adenocarcinomas. Peripheral blood and peritoneal fluid samples were obtained intraoperatively. Patients with benign serous cysts, endometrioma and ovarian malignancies did not differ significantly in terms of their serum and peritoneal fluid concentrations of sHLA-G. Ovarian cancer patients presented with significantly higher median serum concentrations of IL-10 and TNF-alpha than other study subjects. Median concentrations of IL-10 and TNF-alpha in peritoneal fluid turned out to be the highest in ovarian cancer patients, followed by women with endometrioma and subjects with benign serous cysts. All these intergroup differences were statistically significant. Irrespective of the group, median concentrations of sHLA-G, IL-10 and TNF-alpha in peritoneal fluid were higher than serum levels of these markers.
CONCLUSIONS
Elevated serum and peritoneal fluid concentrations of IL-10 and TNF-alpha distinguish ovarian malignancies and endometriomas from benign serous ovarian cysts. In contrast to endometriosis, ovarian malignancies are characterized by elevated peritoneal fluid concentrations of IL-10 and TNF-alpha, elevated serum concentrations of IL-10 and low serum levels of TNF-alpha. Serum and peritoneal fluid concentrations of sHLA-G have no diagnostic value in differentiating between ovarian malignancies and endometriomas.
背景
尽管免疫系统在子宫内膜异位症和卵巢癌的发病机制中均起关键作用，但其功能有所不同。因此，我们推测，特定的免疫参数可作为这两种疾病的诊断标志物。本研究旨在比较患有特定卵巢病变（良性浆液性囊肿、子宫内膜异位囊肿和恶性肿瘤）的女性血清和腹腔液中可溶性人类白细胞抗原G（sHLA-G）、白细胞介素10（IL-10）和肿瘤坏死因子α（TNF-α）的浓度。将这些指标用于浆液性卵巢囊肿、子宫内膜异位症和卵巢癌女性的诊断目的的临床意义，这在未来可能会改善卵巢疾病的早期诊断。
病例报告
该研究纳入了因良性浆液性卵巢囊肿、卵巢子宫内膜异位囊肿和浆液性卵巢腺癌接受手术治疗的女性。术中获取外周血和腹腔液样本。良性浆液性囊肿、子宫内膜异位囊肿和卵巢恶性肿瘤患者的血清和腹腔液中sHLA-G浓度无显著差异。卵巢癌患者血清中IL-10和TNF-α的中位数浓度显著高于其他研究对象。腹腔液中IL-10和TNF-α的中位数浓度在卵巢癌患者中最高，其次是患有子宫内膜异位囊肿的女性和患有良性浆液性囊肿的患者。所有这些组间差异均具有统计学意义。无论组别如何，腹腔液中sHLA-G、IL-10和TNF-α的中位数浓度均高于这些标志物的血清水平。
结论
血清和腹腔液中IL-10和TNF-α浓度升高可将卵巢恶性肿瘤和子宫内膜异位囊肿与良性浆液性卵巢囊肿区分开来。与子宫内膜异位症不同，卵巢恶性肿瘤的特征是腹腔液中IL-10和TNF-α浓度升高、血清中IL-10浓度升高以及血清中TNF-α水平降低。sHLA-G的血清和腹腔液浓度在区分卵巢恶性肿瘤和子宫内膜异位囊肿方面无诊断价值。
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