Gynecological Oncology Center, Peking University People's Hospital, Beijing 100044, China.
Department of Materials Science and Engineering, Peking University, Beijing 100871, China.
Chin Med J (Engl). 2017 Oct 5;130(19):2339-2345. doi: 10.4103/0366-6999.215325.
Circulating endometrial cells (CECs) have been reported to be present in the peripheral blood of women with endometriosis (EM), providing clear and specific evidence of the presence of ectopic lesions. In this study, we established a method with a high detection rate of CECs, assessed the diagnostic value of CECs for EM and compared with serum CA125, and proposed a hypothesis for the pathogenesis of EM from the new perspective of CECs.
The participants were enrolled prospectively from October 2015 to July 2016. The peripheral blood samples were collected from 59 participants, and the blood cells were isolated for immunofluorescence staining via microfluidic chips. The cells that were positive for vimentin/cytokeratin and estrogen/progesterone receptor and negative for CD45 were identified as CECs. The serum CA125 level was tested with electrochemiluminescence immunoassay.
The detection rate of CECs reached 89.5% (17/19) in the EM group, which was significantly higher than that of the control group (15.0% [6/40], P < 0.001) and was independent of menstrual cycle phases. Furthermore, a positive CEC assay detected 4/5 cases of Stage I-II EM. In contrast, a positive CA125 test had limited value in detecting EM (13/19, 68.4%) and detected only one case of Stage I-II EM.
CECs are promising biomarkers for EM with great potential for a noninvasive diagnostic assay.
已有研究报道，子宫内膜异位症（EM）患者的外周血中存在循环的子宫内膜细胞（CECs），这为异位病灶的存在提供了明确而特异的证据。本研究建立了一种高灵敏度的 CECs 检测方法，评估了 CECs 对 EM 的诊断价值，并与血清 CA125 进行了比较，从 CECs 的新视角提出了 EM 发病机制的假说。
本前瞻性研究于 2015 年 10 月至 2016 年 7 月入组了 59 名参与者。采集外周血样，通过微流控芯片分离血细胞进行免疫荧光染色，将表达波形蛋白/细胞角蛋白、雌激素/孕激素受体且 CD45 阴性的细胞鉴定为 CECs。采用电化学发光免疫分析法检测血清 CA125 水平。
EM 组的 CECs 检出率达到 89.5%（17/19），明显高于对照组（15.0%[6/40]，P<0.001），且与月经周期无关。此外，CEC 检测阳性可检出 4/5 例Ⅰ期-Ⅱ期 EM。相比之下，CA125 检测对 EM 的诊断价值有限（13/19，68.4%），仅能检出 1 例Ⅰ期-Ⅱ期 EM。
CECs 是 EM 很有前途的生物标志物，具有很大的非侵入性诊断检测潜力。
