卵巢型子宫内膜异位症患者血清及腹腔冲洗液中Tim-3和Gal-9的表达及意义OA

Objective:To detect the expressions of T-cell immunoglobulin mucin-3(Tim-3)and galectin-9(Gal-9)in the serum and peritoneal lavage fluid of patients with ovarian endometriosis(EMT),and to explore their potential value for evaluating the disease progression and non-invasive diagnosis of ovarian EMT.Methods:37 patients with ovarian EMT who underwent surgical treatment at The Second Affiliated Hospital of Kunming Medical University from March to December 2024 were selected as the case group,and 37 patients with infertility caused by benign fallopian tube disease(fallopian tube obstruction,hydrosalpinx)and benign ovarian tumors re-quiring surgical treatment during the same period were selected as the control group.The preoperative fasting ve-nous blood and intraoperative peritoneal lavage fluid of the two groups of patients were collected,and the expres-sions of Tim-3 and Gal-9 were detected by enzyme-linked immunosorbent assay(ELISA).We analyzed the ex-pression differences of Tim-3 and Gal-9 between the case group and the control group,explore the relationship between the expression of the two and disease progression in patients with ovarian EMT,and draw the receiver operating characteristic(ROC)curve to analyze the diagnostic efficacy of single and combined detection of Tim-3 and Gal-9 in serum for ovarian EMT.Results:The expressions of Tim-3 and Gal-9 in serum and peritoneal lavage fluid of ovarian EMT patients were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).The expression levels of Tim-3 and Gal-9 in serum and peritoneal lavage fluid of patients with ovarian EMT in ASRM stage Ⅲ-Ⅳ were higher than those in ASRM stage Ⅰ-Ⅱ,and the difference was statistically significant(P<0.05).There was no significant relationship between the expression of TIM-3 and Gal-9 and dysmenorrhea(P>0.05).The expressions of Tim-3 and Gal-9 in peritoneal lavage fluid of ovarian EMT patients were significantly higher than those in serum,and the differences were statistically significant(P<0.001).ROC analysis showed that the cut-off value of serum Tim-3 and Gal-9 in the diagnosis of ovarian EMT was 64.62 pg/ml and 3.74 pg/ml,respectively,the area under the curve(AUC)was 0.698 and 0.672,respectively,and the sensitivity was 64.9%and 67.6%,respectively.The specificities of the two indexes were 75.7%and 70.3%;The AUC of the combination of Tim-3 and Gal-9 was 0.726,the sensitivity was 75.7%,and the specificity was 62.2%,which was inferior to the diagnostic efficiency of Tim-3 or Gal-9 alone(P<0.05).Conclusions:Tim-3 and Gal-9 play important roles in the immune regulatory mechanism of ovarian EMT.Their expressions are related to the an-atomical severity of EMT and have certain value for the diagnosis of ovarian EMT.They are expected to become potential biomarkers for non-invasive diagnosis of this disease and assessment of disease progression.