血清巨噬细胞移动抑制因子诊断子宫内膜异位症及其严重程度的病例对照研究。
Serum macrophage migration inhibition factor for diagnosing endometriosis and its severity: case-control study.
机构信息
Obstetric and Gynecology Department, Fayoum University, 23 Mohammed Gonemy of mohammed Elmakreef 6th district, nasr city, Cairo, Fayoum, Egypt.
出版信息
BMC Womens Health. 2020 Sep 3;20(1):189. doi: 10.1186/s12905-020-01051-0.
BACKGROUND
Endometriosis is a long-standing progressive disease that affects women of reproductive age. Macrophage migration inhibitory factor (MIF) is one of non-invasive blood biomarker that was detected in sera of endometriotic patients. The present study aimed to determine the accuracy of serum MIF in diagnosing endometriosis in women with infertility and chronic pelvic pain, and correlate its level to the stage of the disease.
METHODS
Observational case-control study conducted at Fayoum University hospital from March 2016 till September 2018. Three hundred women candidate for diagnostic laparoscopy for either infertility or gynecologic chronic pelvic pain were included. The study group included patients with symptoms suggestive of endometriosis or chocolate cyst by ultrasound and proved by laparoscopy and histopathology. The control group included other causes of infertility or pelvic pain. All patients undergone either diagnostic or operative laparoscopy, and before laparoscopy blood sampling for quantitative measurement of macrophage migration inhibitory factor (MIF) protein in serum by ELISA technique.
RESULTS
The level of serum MIF was significantly higher in endometriosis group compared to control group (1.75 ± 1.48 pg/ml and 0.51 ± 0.45 pg/ ml, respectively, P = < 0.001), with a progressive increase with advancing stage (stage I, 1.3 ± 1.03 pg/ml, stage II, 1.7 ± 1.57 pg/ml, stage III, 2.1 ± 1.19 pg/ml and in stage IV, 3.2 ± 2.6 pg/ml). Moreover, in patients presented with pain and infertile patients showed significantly higher levels of serum MIF (1.92 ± 1.13 vs 1.21 ± 1.17 and 1.82 ± 1.13 vs 1.32 ± 0.91 respectively with p-value < 0.001). ROC curve of serum MIF with a cut off value of 0.85 pg/ml or more achieves a sensitivity of 80.6%, specificity of 83.3%, positive predictive value of 82.9% and negative predictive value of 81.2%.
CONCLUSION
Serum MIF might be a promising marker not only for noninvasive diagnosis of endometriosis but as a target for detecting severity as well.
背景
子宫内膜异位症是一种长期进行性疾病，影响育龄妇女。巨噬细胞移动抑制因子（MIF）是一种非侵入性血液生物标志物，已在子宫内膜异位症患者的血清中检测到。本研究旨在确定血清 MIF 在诊断不孕和慢性盆腔疼痛妇女子宫内膜异位症中的准确性，并将其水平与疾病分期相关联。
方法
这是一项 2016 年 3 月至 2018 年 9 月在法尤姆大学医院进行的观察性病例对照研究。纳入了 300 名因不孕或妇科慢性盆腔疼痛而接受诊断性腹腔镜检查的女性候选者。研究组包括超声提示子宫内膜异位症或巧克力囊肿并经腹腔镜和组织病理学证实的患者。对照组包括其他不孕或盆腔疼痛的原因。所有患者均行诊断性或手术性腹腔镜检查，术前采血用 ELISA 技术定量检测血清中巨噬细胞移动抑制因子（MIF）蛋白。
结果
与对照组相比，子宫内膜异位症组血清 MIF 水平显著升高（分别为 1.75±1.48pg/ml 和 0.51±0.45pg/ml，P<0.001），且随分期进展而逐渐升高（I 期 1.3±1.03pg/ml，II 期 1.7±1.57pg/ml，III 期 2.1±1.19pg/ml，IV 期 3.2±2.6pg/ml）。此外，在表现为疼痛和不孕的患者中，血清 MIF 水平显著升高（1.92±1.13 vs 1.21±1.17 和 1.82±1.13 vs 1.32±0.91，P<0.001）。血清 MIF 的 ROC 曲线，截断值为 0.85pg/ml 或更高，其灵敏度为 80.6%，特异性为 83.3%，阳性预测值为 82.9%，阴性预测值为 81.2%。
结论
血清 MIF 不仅可能是一种有前途的非侵入性子宫内膜异位症诊断标志物，而且可能是一种检测严重程度的标志物。
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