Abstract：Objective To explore the expression of C-reactive protein (CRP), interleukin-8 (IL-8) and vascular endothelial growth factor (VEGF) in serum and peritoneal fluid of patients with endometriosis and its clinical significance. Methods A total of 93 patients with endometriosis (endometriosis group) admitted to Qinghai Red Cross Hospital from August 2015 to August 2017 were divided into stage Ⅰ (n = 19), stage Ⅱ (n = 25), stage Ⅲ (n = 28) and stage Ⅳ (n = 21) according to the American Fertility Society (r-AFS). At the same time, 60 patients with uterine leiomyoma (uterine leiomyoma group) and 60 healthy volunteers as control group were randomly selected. The levels of CRP, IL-8 and VEGF in serum and peritoneal fluid was detected by enzyme-linked immunosorbent assay. Results The levels of serum CRP, IL-8 and VEGF in endometriosis group were higher than those in uterine leiomyoma group and control group (P < 0.05). The levels of CRP, IL-8 and VEGF in peritoneal fluid were higher than those in patients with uterine leiomyoma group (P < 0.05). With the increase of disease stages, the levels of CRP, IL-8 and VEGF in serum and peritoneal fluid in patients with endometriosis increased gradually (P < 0.05). Pearson moment correlation analysis showed that serum CRP, IL-8, VEGF was positively associated with r-AFS score (r = 0.639, 0.712, 0.655; P < 0.05), and which in peritoneal fluid was positively associated with r-AFS score (r = 0.682, 0.764, 0.670; P < 0.05). The area under ROC curve (AUC) of CRP was 0.784, the best cut-off value was 12.23 mg/L, the sensitivity and specificity was 0.77 and 0.72, respectively, and the accuracy was 0.71. The AUC of IL-8 was 0.884, the best cut-off value was 20.97 mg/L, the sensitivity and specificity was 0.82 and 0.76, respectively, and the accuracy was 0.78. The AUC of VEGF was 0.889, the best cut-off value was 175.34 pg/mL, the sensitivity and specificity were 0.82 and 0.78, respectively, and the accuracy was 0.80. The AUC of CRP, IL-8 and VEGF was 0.931, the sensitivity and specificity was 0.92 and 0.85, respectively, and the accuracy was 0.89. Conclusion The levels of CRP, IL-8 and VEGF in serum and peritoneal fluid of patients with endometriosis are significantly elevated and positively associated with the progression of the disease. Early detection of CRP, IL-8 and VEGF is helpful to differential diagnosis of endometriosis and to evaluate the severity of the disease.
魏顺英 王烈宏 祁青玲 王乾印 王永花 贾佳. 子宫内膜异位症患者血清与腹腔液中CRP、IL-8、VEGF的表达及临床意义[J]. 中国医药导报, 2019, 16(12): 89-92,104.
WEI Shunying WANG Liehong QI Qingling WANG Qianyin WANG Yonghua JIA Jia. Expression of CRP, IL-8 and VEGF in serum and peritoneal fluid of patients with endometriosis and its significance. 中国医药导报, 2019, 16(12): 89-92,104.
[1] Bulun SE. Endometriosis [J]. N Engl J Med，2009，360（3）：268-279.
[2] Mehedintu C，Plotogea MN，Lonescu S，et al. Endometriosis still a challenge [J]. J Med Life，2014，7（3）：349-357.
[3] Bazot M，Darai E. Diagnosis of deep endometriosis：clinical examination，ultrasonography，magnetic resonance imaging，and other techniques [J]. Fertil Steril，2017，108（60）：886-894.
[4] Nazir S，Usman Z，Imran M，et al. Women Diagnosed with Endometriosis Show High Serum Levels of Diethyl Hexyl Phthalate [J]. J Hum Reprod Sci，2018，11（2）：131-136.
[5] Zhang F，Liu XL，Wang W，et al. Expression of MMIF，HIF-1α and VEGF in Serum and Endometrial Tissues of Patients with Endometriosis [J]. Curr Med Sci，2018，38（3）：499-504.
[6] Riiskj?覸r M，Forman A，Kesmodel US，et al. Diagnostic Value of Serial Measurement of C-Reactive Protein in the Detection of a Surgical Complication after Laparoscopic Bowel Resection for Endometriosis [J]. Gynecol Obstet Invest，2017，82（4）：410-416.
[7] Singh AK，Dutta M，Chattopadhyay R，et al. Intrafollicular interleukin-8，interleukin-12，and adrenomedullin are the promising prognostic markers of oocyte and embryo quality in women with endometriosis [J]. J Assist Reprod Genet，2016，33（10）：1363-1372.
[8] Acimovic M，Vidakovic S，Milic N，et al. Survivin and VEGF as Novel Biomarkers in Diagnosis of Endometriosis [J]. J Med Biochem，2016，35（1）：63-68.
[9] Zeng C，Xu JN，Zhou Y，et al. Reproductive performance after surgery for endometriosis：predictive value of the revised American Fertility Society classification and the endometriosis fertility index [J]. Gynecol Obstet Invest，2014， 77（3）：180-185.
[10] 胡方方，杨舒心，刘广芝.卵巢子宫内膜异位症恶变的临床病理特征分析[J].现代妇产科进展，2017，26（12）：905-907.
[11] 白治苗，姚卫卫，李望舒，等.骨桥蛋白在子宫内膜异位症中介导细胞迁移与依赖核转录因子kB通路促进机制金属蛋白酶及尿激酶型纤溶酶原激活物表达中的作用研究[J].中国全科医学，2016，19（24）：2930-2934.
[12] Balkowiec M，Maksym RB，W?覥odarski PK. The bimodal role of matrix metalloproteinases and their inhibitors in etiology and pathogenesis of endometriosis （Review) [J]. Mol Med Rep，2018，18（3）：3123-3136.
[13] Klemmt PAB，Starzinski-Powitz A. Molecular and Cellular Pathogenesis of Endometriosis [J]. Curr Womens Health Rev，2018，14（2）：106-116.
[14] Borghese B，Santulli P，Marcellin L，et al. Definition，description，clinicopathological features，pathogenesis and natural history of endometriosis：CNGOF-HAS Endometriosis Guidelines [J]. Gynecol Obstet Fertil Senol，2018，46（3）：156-167.
[15] 苗卉，苗聪秀，李娜，等.子宫内膜异位症患者IL-8、VEGF及CRP的表达及其R-AFS分期的相关性研究[J].中国妇幼保健，2015，30（25）：4288-4290.
[16] Kianpour M，Nematbakhsh M，Ahmadi SM. C-reactive protein of serum and peritoneal fluid in endometriosis [J]. Iran J Nurs Midwifery Res，2012，17（2 Suppl 1）：S115-S119.
[17] 彭洁，安娜，马骏麒.血清IL-8、hsCRP、Lp（a)水平与冠心病的发生和病情严重性的关系[J].心血管康复医学杂志，2018，27（4）：444-448.
[18] 潘佳，马汝婵，陈友国，等.VEGF、IL-6、IL-8在子宫内膜异位症患者血清和腹腔液中的表达[J]. 湖南师范大学学报：医学版，2015，12（5）：15-17.
[19] Leone Roberti Maggiore U，Ferrero S. Methodological concerns regarding levels of vascular endothelial growth factor （VEGF）in serum of women with endometriosis [J]. Int J Fertil Steril，2015，8（40）：485-486.
[20] 方敏.子宫内膜异位症患者血清及组织CA125、TNF-α和VEGF水平联合检测的临床意义[J].中国实验诊断学，2014，18（12）：2027-2029.
[21] 王菲菲，龚晔晟，张洁琼，等.子宫内膜异位症患者血清和腹腔液中VEGF、IL-6、IL-8的表达情况及临床意义[J].北京医学，2015，37（2）：138-141.
[22] 范玉香.VEGF、IL-6、IL-8在子宫内膜异位症患者血清和腹腔液的表达及意义[J].海南医学院学报，2015，21（11）：1525-1527，1531.
2019, Vol. 16 
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