Madjid Tita Husnitawati, Ardiansyah Dennis Fachmi, Permadi Wiryawan, Hernowo Bethy
Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital-Universitas Padjadjaran, Bandung 40161, Indonesia.
Department of Pathology, Hasan Sadikin General Hospital-Universitas Padjadjaran, Bandung 40161, Indonesia.
Diagnostics (Basel). 2020 Jun 2;10(6):364. doi: 10.3390/diagnostics10060364.
Endometriosis is a gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity. Remodeling of the extracellular matrix (ECM) is a prerequisite for tissue implantation. The presence of matrix metalloproteinase (MMP) and its inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1), in shed endometrium cells has a significant role in ECM degradation. A case-control study was performed to find other diagnostic markers using menstrual blood. We examined a sample of 68 women who visited the gynecology clinic in Dr Hasan Sadikin General Hospital, 40% of whom were confirmed to have endometriosis, and the rest tested negative by histopathological examination. All endometriotic cases presented MMP-9 and TIMP-1 expression with different cell distribution. MMP-9 expression in endometriosis patients was increased compared to the controls ( = 0.002). Expression of MMP-9 in >80% of endometrial cells was associated with a higher risk for endometriosis (OR 4.44 95% CI 1.31 to 15.56) compared to MMP-9 expression in 50%-80% of cells. TIMP-1 cell expression in women with endometriosis was lower than in the control group ( = 0.030). Subjects with TIMP-1 expression in 20%-50% of endometrial cells had a higher risk for endometriosis (OR 4.5, 95%CI 1.21-17.42) compared those with TIMP-1 expression in 50%-80% of cells. These expressions levels can be useful to predict endometriosis.
子宫内膜异位症是一种妇科疾病，其特征是子宫腔外存在类似子宫内膜的组织。细胞外基质（ECM）的重塑是组织植入的先决条件。脱落的子宫内膜细胞中基质金属蛋白酶（MMP）及其抑制剂金属蛋白酶组织抑制剂-1（TIMP-1）的存在在ECM降解中起重要作用。进行了一项病例对照研究，以寻找使用月经血的其他诊断标志物。我们检查了68名到哈桑·萨迪金综合医院妇科门诊就诊的女性样本，其中40%被确诊为子宫内膜异位症，其余经组织病理学检查呈阴性。所有子宫内膜异位症病例均呈现MMP-9和TIMP-1的不同细胞分布表达。与对照组相比，子宫内膜异位症患者中MMP-9的表达增加（P = 0.002）。与50%-80%的细胞中MMP-9表达相比，超过80%的子宫内膜细胞中MMP-9表达与子宫内膜异位症的较高风险相关（OR 4.44，95%CI 1.31至15.56）。子宫内膜异位症女性中TIMP-1细胞表达低于对照组（P = 0.030）。与50%-80%的细胞中TIMP-1表达相比，20%-50%的子宫内膜细胞中TIMP-1表达的受试者患子宫内膜异位症的风险更高（OR 4.5，95%CI 1.21-17.42）。这些表达水平可用于预测子宫内膜异位症。
