| Objectives To evaluate the changes of serum and peritoneal fluid soluble cell adhesion molecules-1(sICAM-1) and CA125 in endometriosis(EM) and their relationship in the genesis of EM before and after conservative laparoscopic surgery in patients. Methods The sICAM-1 and CA125 levels in serum andperitoneal fluid of 60 endometriotic patients(8 women with stage 1.12 women stage II . 18 women stage III and 22 women stage IV) and 30 control patients were determined by ELISA. And their serum changes were measured by ELISA before and after conservative laparoscopic surgery in patients with EM. The expression of 1CAM-1(CD54) were evaluated by immunohistochemistry in 40 endometriotic tissues of patients with endometriosis and 30 endometrium from uon-endometriosis subjects during the same menstrual phase.Results (1) The serum levels of sICAM-1 in EM were higher than that in control women (P<0.05) .Serum levels of sICAM-1 in stage Illor IVof EM were higher or significantly higher than that in control group (P<0.05 or P<0.01) . There was no difference between serum levels in stage I or II and in control group (P<0.05) , in stage I and II, or in stage Illand IV. But Serum levels of sICAM-1 in stage III orlV were higher or significantly higher than that in stage I or II . (2) The peritoneal fluid levels of sICAM-1 in EM were higher than that in control women ( P<0.05 ) .There was no difference between peritoneal fluid levels in stage I and II, in stage III and IV,or in stage I or II EM and4control group (P<0.05) . Peritoneal fluid levels of sICAM-l in stage III or IV were higher or significantly higher than that in control women ( P<0.05 ) ,or that in stage I and II (P<0.05 or P<0.0l). (3) The serum levels of CA125 in EM were higher than that in control group (P<0.05). Serum levels of CA125 in stage IV were higher than that in control group (P<0.05), but there was no difference between serum levels of CA125 in stage I , II or III and control group (P>0.05). There was no difference between serum levels of CA125 in each stage of EM too (P>0.05).(4) There was no difference between peritoneal fluid levels of CA125 in EM and control women (P>0.05). (5) Significant parallel relationship existed between the stage of EM and the sICAM-l levels in serum and peritoneal fluid in EM patients (r values: serum:0.594; peritoneal fluid:0.605. P<0.0l). But there was no parallel relationship between the stage of EM and the CA125 levels in serum and peritoneal fluid in EM women (r values: serum:0.l!3, peritoneal fluid:0.!96 , P>0.05).(6) There was no parallel relationship between the sICAM-l and the CA.125 levels in serum or peritoneal fluid in EM women (r values: serum: -0.056, peritoneal fluid: 0.419, P>0.05).(7) Suppose the normal range of concentration of serum sICAM-l was 0~475ng/ml. the sensitivity of EM in this research is 63.33%. the specificity is 85.71%. If the diagnosis standard of EM by CA125 was above 35u/ml, then the sensitivity is 36.67%, the specificity is 85.71%.(8) After clearance of endometriosis foci with laparoscopic conservative surgery, the sICAM-1 serum levels decreased significantly (P<0.01) .While no difference of serum CA125 levels was found before and after conservative laparoscopic surgery in patients with EMC P>0.05 ).(9) ICAM-1 were expressed in all 40 endometriotic tissues(l 00%).while the expression of ICAM-1 were only in 5 out5of the 30 cases of endometrium from non-endometriosis women. Conclusion (1) The sICAM-1 may play an important role in the pathogenesis and progrssion of EM. Because there might be significant relationship between the high levels of sICAM-1 in serum and peritoneal fluid of EM patients and increased numbers of peritoneal macrophages or more secreted sICAM-1 by isolated endometriotic stromal cells. As a soluble receptor, sICAM-1 competes with LFA-1 of immunocyte extracellular membrane, and binds or decreases immunocyte activity ,for example , NK cell and T-cell autoimmune activation . One mechanism by which evasion of immuno...
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