Division of Reproductive Endocrinology and Infertility, Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Department of Genetics and Genome Sciences, Department of Pediatrics and National Center of Regenerative Medicine, Case Western Reserve University, Biomedical Research Building #822, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
J Assist Reprod Genet. 2020 Dec;37(12):2999-3006. doi: 10.1007/s10815-020-01989-y. Epub 2020 Oct 30.
To compare growth factor and cytokine profiles in the endometrial secretions of patients with and without endometriosis to determine whether a particular protein profile is predictive of the disease.
Patients undergoing laparoscopic gynecologic surgery for benign indications were recruited for this prospective cohort study. Prior to surgery, endometrial fluid was aspirated and multiplex immunoassay was used to quantify 7 cytokines and growth factors. During surgery, each patient was staged according to the ASRM staging system for endometriosis. Cytokines and growth factors were evaluated using the Mann-Whitney and Kruskal-Wallis tests. Combinations of cytokines were evaluated using logistic regression analysis, and ROC curves were generated to evaluate the predictive capacity of the assay.
Endometrial secretions were analyzed from 60 patients. Nineteen had stage 3-4 endometriosis, 19 had stage 1-2 disease, and 22 had no endometriosis. There were no significant differences between controls and stage 1-2 endometriosis; however, levels of IL-1α and IL-6 were significantly increased in women with moderate-to-severe disease. A combination of IL-1α, IL-1β, and IL-6 in endometrial secretions predicts stage 3-4 endometriosis with an AUC of 0.78. A threshold value of 118 pg/mL yields a sensitivity of 75% and specificity of 70%.
Aspiration of endometrial fluid is a safe and effective approach for evaluating the endometrial profile of women with endometriosis. Women with moderate-to-severe endometriosis demonstrate a distinct cytokine profile compared to controls. A combination of IL-1α, IL-1β, and IL-6 in the endometrial secretions is predictive of stage 3-4 endometriosis, but is not predictive of minimal-to-mild disease.
比较子宫内膜分泌液中生长因子和细胞因子谱在子宫内膜异位症患者和非子宫内膜异位症患者中的差异，以确定是否存在特定的蛋白谱可预测该疾病。
本前瞻性队列研究招募了因良性指征接受腹腔镜妇科手术的患者。手术前，抽吸子宫内膜液，采用多重免疫分析法定量检测 7 种细胞因子和生长因子。手术过程中，根据子宫内膜异位症的 ASRM 分期系统对每位患者进行分期。采用 Mann-Whitney 和 Kruskal-Wallis 检验评估细胞因子和生长因子。采用逻辑回归分析评估细胞因子组合，绘制 ROC 曲线评估检测的预测能力。
分析了 60 名患者的子宫内膜分泌物。19 名患者患有 3-4 期子宫内膜异位症，19 名患者患有 1-2 期疾病，22 名患者无子宫内膜异位症。对照组和 1-2 期子宫内膜异位症患者之间无显著差异；然而，中重度疾病患者的 IL-1α 和 IL-6 水平显著升高。子宫内膜分泌物中 IL-1α、IL-1β 和 IL-6 的组合预测 3-4 期子宫内膜异位症的 AUC 为 0.78。118pg/ml 的阈值可获得 75%的敏感性和 70%的特异性。
抽吸子宫内膜液是评估子宫内膜异位症患者子宫内膜特征的一种安全有效的方法。中重度子宫内膜异位症患者与对照组相比表现出独特的细胞因子谱。子宫内膜分泌液中 IL-1α、IL-1β 和 IL-6 的组合可预测 3-4 期子宫内膜异位症，但不能预测轻度疾病。
