目的 分析子宫内膜异位症(EMs)患者异位病灶组织中过氧化物酶体增殖物激活受体(PPARs)3种不同亚型(PPAR-α、PPAR-β和PPAR-γ)的表达水平,以期为该疾病的诊断提供新方法.方法 选取2021年4-12月在该院行腹腔镜手术治疗的30例EMs患者的异位子宫内膜组织为试验组,另选取同期行腹腔镜手术治疗的30例卵巢成熟性囊性畸胎瘤(MCTO)患者的卵巢病灶组织为对照组.采用免疫组织化学法检测病灶组织中PPAR-α、PPAR-β及PPAR-γ的表达情况,并分析其在试验组与对照组中的表达差异.应用受试者工作特征(ROC)曲线评价PPAR-α/PPAR-β、PPAR-α/PPAR-γ和PPAR-β/PPAR-γ比值对EMs的诊断价值.结果 试验组患者病灶组织PPAR-α、PPAR-β及PPAR-γ表达水平明显高于对照组(P＜0.05);EMs患者以PPAR-α 表达为主(P＜0.05),而 MCTO 患者以 PPAR-γ 表达为主(P＜0.05).在 PPAR-α/PPAR-β 诊断EMs的ROC曲线中,当截断值为1.251时,曲线下面积(AUC)为0.65(95％CI:0.51～0.80),灵敏度为90.00％,特异度为50.00％;在PPAR-α/PPAR-γ诊断EMs的ROC曲线中,当截断值为0.817时,AUC为0.88(95％CI:0.78～0.99),灵敏度为 96.67％,特异度为 80.00％;在 PPAR-β/PPAR-γ 诊断 EMs 的 ROC 曲线中,当截断值为0.755时,AUC为0.91(95％CI:0.82～1.00),灵敏度为100.00％,特异度为86.67％.结论 EMs患者异位病灶组织PPAR-α表达明显高于PPAR-β和PPAR-γ,而 MCTO患者病灶组织以PPAR-γ表达为主.PPAR-β/PPAR-γ可能成为诊断EMs的潜在生物标志物.
Objective To analyze the expression levels of the three different subtypes of peroxisome proliferator-activated receptors(PPARs),including PPAR-α,PPAR-β and PPAR-γ,in the ectopic lesion tis-sues of the patients with endometriosis(EMs)in order to provide new methods for this disease diagnosis.Methods The ectopic endometrial tissue samples from 30 patients with EMs treated by laparoscopic surgery in this hospital from April to December 2021 were selected as the experimental group,and the ovarian lesion tissue samples from 30 patients with mature cystic teratoma of the ovary(MCTO)during the same period treated by laparoscopic surgery were selected as the control group.The expression levels of PPAR-α,PPAR-βand PPAR-γ in lesion tissues were detected by using immunohistochemistry,and their expression differences between the experimental group and control group were analyzed.The receiver operating characteristic(ROC)curve was utilized to evaluate the diagnostic value of the ratios of PPAR-α/PPAR-β,PPAR-α/PPAR-γ,and PPAR-β/PPAR-γ for EMs.Results The expression levels of PPAR-α,PPAR-β and PPAR-γ in the lesion tis-sues of the experimental group were significantly higher than those of the control group(P＜0.05).In the pa-tients with EMs,PPAR-α was predominantly expressed(P＜0.05),whereas in the patients with MCTO,PPAR-γ was predominantly expressed(P＜0.05).In the ROC curve of PPAR-α/PPAR-β ratio for diagnosing EMs,when the cutoff value was 1.251,the area under the curve(AUC)was 0.65(95％CI:0.51-0.80),the sensitivity was 90.00％,and the specificity was 50.00％.In the ROC curve of PPAR-α/PPAR-γ ratio for diag-nosing EMs,when the cutoff value was 0.817,AUC was 0.88(95％CI:0.78-0.99),the sensitivity was 96.67％and the specificity was 80.00％.In the curve of the PPAR-β/PPAR-γ ratio for diagnosing EMs,when the cutoff value was 0.755,AUC was 0.91(95％CI:0.82-1.00),the sensitivity was 100.00％,and the speci-ficity was 86.67％.Conclusion The expression of PPAR-α in the ectopic lesion tissues of the patients with EMs is significantly higher than that of PPAR-β and PPAR-γ,while in lesion tissues of the patients with MC-TO,the PPAR-γ expression is predominant.The PPAR-β/PPAR-γ ratio may become a potential biomarker for diagnosing EMs.
罗勤;田敏;高爽;黄洁;刁戈;李力;韩健;郭建新
陆军军医大学大坪医院妇产科,重庆 400042
临床医学
子宫内膜异位症;过氧化物酶体增殖物激活受体;免疫组织化学;临床特征;诊断价值
endometriosis;peroxisome proliferator-activated receptors;immunohistochemistry;clinical features;diagnostic value
《重庆医学》 2024 (013)
1952-1958 / 7
重庆市科卫联合中医药科研项目(2019ZY23464).
10.3969/j.issn.1671-8348.2024.13.006
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