| Background and ObjectiveEndometriosis (EMs) is a general disease of gynaecology which nature of the benign and the behavior is similar to malignant tumor. EMs refers to the functional endometrial (glands and stroma) growth in other parts of the body outside the uterine cavity, mainly in the place such as genital, bladder, rectum and peritoneum. It is more common in women of childbearing age and the incidence is about10%～15%. The incidence of EMs has obvious rising trend in recent years, seriously impacting on women’s health and quality of life. The pathogenesis of EMs remains unclear, studies confirm that immune function in EMs patients with dysfunction and various cytokines, including a large number of inflammatory cytokine changes in number and activity which form a positive feedback to expand non-bacterial inflammatory response and promot the development of EMs. Therefore, EMs as an immune deficiency leading to inflammation-related diseases, especially the inflammation of abdominal cavity microenvironment had a greater influence on the growth and proliferation of ectopic endometrial cells. High mobility group protein B1(HMGB1) is a content-rich, highly conservative non-histone, widely found in nucleus of eukaryotic organisms. In recent years, studies have shown that HMGB1may adjust the inflammation process, also have an important impact on the development of EMs. Reports of HMGB1to EMs are less at home and abroad, so HMGB1has not yet been considered applied to clinical diagnosis of EMs.Retinol binding protein4(RBP4) is an adipocytokines mainly secreted by the liver. In recent years it has been found that RBP4is a protein secreted by fat cell with variety of biological activities. In terms of gene, RBP4is associated with inflammatory markers. Studies have shown that RBP4content increased in response to elevated levels in peritoneal fluid of EMs patients. At present, the research about RBP4level in serum of EMs patients are very little.Cancer antigen125(CA125) is one of the most studied tumor markers by far with certain value to the diagnosis of EMs, but it is not the markup antigen of EMs, the diagnosis sensitivity and speciality degree is low, so we need to combine other indicators to improve the diagnosis of EMs.It has not been reported about the joint detection of HMGB1, RBP4and CA125in the serum levels of EMs patients domestic and overseas. In this experiment,the HMGB1, RBP4and CA125in the serum levels of EMs patients are detected and correlation analysis in them, aiming to discusses the relations of them in the development and progression of EMs and analyze the diagnostic value of them, in order to obtain guidance in the clinically non-invasive diagnosis in EMs.Materials and methods1. Experimental groups1.1Experimental group:In our hospital,60patients were chosen from November2011to October2012. All of them, aged from20to47, were diagnosed for EMs after laparoscopic surgery, with average age31.3. According to the staging standard of r-AFS in1985, Ⅰ-Ⅱ30cases, and III-IV30cases.1.2Control group:Selected55cases in patients given laparoscopic surgery (including15cases of tubal infertility,20cases of ovarian mature teratoma and20 cases of ovarian serous cystadenoma) in the same period. All of the patients, aged from19to49, and the average age was34.7.1.3Inclusion criteria:(1) Women of childbearing age, without a history of gynecologic malignant tumors;(2) Preoperative menstrual cycle is normal, at least3months did not use hormonal drugs;(3) No other serious diseases (autoimmune diseases, cardiovascular disease, liver disease, kidney disease, diabetes and cancer);(4) No acute pelvic inflammation and other pelvic changes.2. Experimental methodsTheir fasting elbow venous blood was taken in the early morning. The concentration of HMGB1, RBP4and CA125were detected by ELISA and analyzed by SPSS17.0. There was statistically significant difference (P<0.05).Results1. The serum levels of HMGB1, RBP4and CA125in EMs patients(1) The serum levels of HMGB1, RBP4and CA125in EMs patients were significantly higher than control group (P<0.05)(2) The serum levels of HMGB1, RBP4and CA125in stage Ⅲ-Ⅳ of EMs patients were significantly higher than stage Ⅰ-Ⅱ (P<0.05)2. The diagnostic value of HMGB1, RBP4and CA125of serum in EMs patientsWhen separate detecting of the serum levels of HMGB1, RBP4or CA125was used to diagnose EMs, the sensitivity and the specificity was83.34%,65.45%;86.67%,78.18%;56.67%,81.82%. If the joint test of HMGB1, RBP4and CA125in the serum of EMs patients was used, the parallel experiments of the sensitivity and specificity were92.78%and60.61%and the series experiments were47.78%and96.97%.3. The correlations of HMGB1, RBP4and CA125of serum in EMs patientsThe serum levels of HMGB1were positive correlation with that of RBP4in EMs patients (r=0.801, P<0.05); The serum levels of HMGB1and RBP4had no correlation with that of CA125in EMs patients (r=0.102, P>0.05; r=0.130, P>0.05).Conclusion1. HMGB1, RBP4and CA125maybe involve in the EMs progression. Besides, they also have relevance with the EMs severity.2. The diagnostic value of separate detecting the serum levels of HMGB1, RBP4or CA125is limited; When joint detecting the serum levels of HMGB1, RBP4and CA125, the specificity in series were the highest, so we can try to use this as a serological markers of EMs diagnosis.3. HMGB1and RBP4may take synergetic effect in the development process of EMs. |
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