The Expression Of ERRβ And ERRγ In Severe Endometriosis And Its Correlation With Postoperative Pregnancy

Objective: To study the expression of Estrogen receptor-related receptor β(ERRβ)and ERRγ in severe endometriosis,and to explore the correlation between ERRβ and ERRγ and infertility and postoperative pregnancy in severe endometriosis.Methods: A total of 81 patients(case group)who were admitted to Fujian Maternal and Child Health Hospital from January 2018 to June 2019 and diagnosed as severe(stageⅣ)endometriosis by postoperative pathology were included.During the same period,38 patients(control group)underwent surgery for benign gynecological diseases,matched by age and BMI.1.The expression levels of ERRβ and ERRγ mRNA in the endometrial tissues of the case group and the normal endometrial tissues of the control group were detected by fluorescence quantitative PCR.2.The expression levels of ERRβ and ERRγ in serum were measured by ELISA,and serum AMH,FSH,LH,E2 and CA125 were detected by chemiluminescence.3.Compare the expression differences of ERRβ and ERRγ in tissues and serum of patients in the case group and the control group,analyze the correlation between serum AMH,FSH,LH,E2,CA125 levels and ERRβ and ERRγ levels in severe endometriosis,and evaluate the value of ERRβ and ERRγ in predicting postoperative pregnancy in severe endometriosis.Results:1.Fluorescence quantitative PCR results showed that the relative content of ERRβmRNA in ectopic endometrial tissue in the case group was significantly lower than that in situ endometrial tissue(P < 0.001)and normal endometrial tissue in the control group(P < 0.001).There was no significant difference in the relative content of ERRβ mRNA between that in situ endometrial tissue and normal endometrium in the control group(P = 0.663).2.Fluorescence quantitative PCR results showed that the relative content of ERRγmRNA in ectopic endometrial tissue in the case group was significantly lower than that in situ endometrial tissue(P < 0.001)and normal endometrial tissue in the control group(P < 0.001).The relative content of ERRγ mRNA in situ endometrial tissue of the case group was significantly lower than that in the normal endometrial tissue(P = 0.022).3.ELISA results showed that the levels of ERRβ and ERRγ in serum of the case group were lower than those of the control group,but there was no significant difference(P > 0.05).4.The relative expression level of ERRγ mRNA in ectopic endometrium tissue of patients with high serum CA125 group was higher(P = 0.003).There was no significant correlation between the expression levels of ERRγ mRNA in the in situ endometrium and ERRβ mRNA in the in situ and ectopic endometrium and serum CA125(P > 0.05).5.Correlation analysis showed that the expression level of ERRγ mRNA in the endometrial tissue of patients in the case group was significantly negatively correlated with age,BMI and serum FSH(r =-0.367,P = 0.001;r =-0.323,P =0.003;r =-0.306,P = 0.008),and was significantly positively correlated with AMH and LH/FSH(r = 0.289,P = 0.009;r = 0.233,P = 0.046).There was no significant correlation between the expression levels of ERRβ mRNA in situ and ectopic endometrial tissue in case group and fertility related indexes(P > 0.05).6.After adjusting for age confounding factors,serum FSH and tissue ERRγ mRNA expression levels were correlated with postoperative pregnancy success in patients with severe endometriosis(OR = 0.785,95%CI: 0.622-0.990,P = 0.041;OR = 11.526,95%CI: 1.244-106.784,P = 0.031).7.ROC curve results showed that the area under ROC curve(AUC)of ERRγ and1/FSH were 0.716 and 0.699,respectively.The combined value of the two was higher in predicting the success of postoperative pregnancy(AUC = 0.774;P <0.001;Sensitivity: 0.667;Specificity: 0.805).8.There was a positive correlation between the expression of ERRγ mRNA and serum HDL-C in the case group(r = 0.279;P = 0.012),but had no significant relationship with FBG,TG,TC and LDL-C(P > 0.05).Conclusion:1.In patients with severe endometriosis,the expression of ERRβ and ERRγ in situ and ectopic endometriosis tissues was lower than that in normal endometriosis.Therefore,ERRβ and ERRγ may be closely related to the occurrence and development of endometriosis.2.The expression of ERRγ mRNA in ectopic endometrial tissue is correlated with the level of serum CA125,suggesting that ERRγ mRNA in ectopic endometrial tissue is related to the severity of disease.The expression level of ERRγ mRNA in the endometrial tissue and the level of FSH in serum are correlated with the success of postoperative pregnancy in severe endometriosis,and high expression of ERRγ mRNA and low level of FSH have predictive value for the success of postoperative pregnancy.