血清中雌激素及其代谢产物在子宫内膜非典型性增生诊断中的意义  

Significance of serum estrogen and its metabolites detection in diagnosis of endometrial atypical hyperplasia

作　　者：赵焕焕[1] 杨红芳[1] 李俊玉[1] 李志伟[2] 白雪[1] 葛钟桓 周梅 李利[1] ZHAO Huanhuan;YANG Hongfang;LI Junyu;LI Zhiwei;BAI Xue;GE Zhonghuan;ZHOU Mei;LI Li(Department of Obstetrics and Gynecology,Forth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050011,China;School of Chemistry and Pharmaceutical Engineering,Shijiazhuang University of Science and Technology,Shijiazhuang,Hebei 050018,China;Department of Gynecology,Nanpi County Hospital,Cangzhou,Hebei 061500,China)

机构地区：[1]河北医科大学第四医院妇科,石家庄050011 [2]河北科技大学化学与制药工程学院,石家庄050018 [3]河北省沧州市南皮县医院妇科,061500

出　　处：《重庆医学》2022年第22期3910-3914,共5页Chongqing medicine

摘　　要：目的探讨雌激素及其代谢产物的变化与子宫内膜非典型性增生发生的关系。方法选择2019年1月至2020年1月河北医科大学第四医院收治的70例子宫内膜非典型性增生患者(非典型性增生组,再分为非肥胖组39例,肥胖组31例)及80例子宫内膜不伴非典型性增生患者作为观察组(不伴非典型性增生组,分再为非肥胖组45例,肥胖组35例),选择同期行体检健康绝经前妇女60例作为对照组(再分为非肥胖组30例,肥胖组30例),留取治疗前血清标本,应用高效液相色谱-质谱法(UPLC-MS)检测血清中雌激素雌二醇(E 2)及其代谢产物4-羟雌二醇(4-OHE 2)、雌酮(E 1)、2-甲氧雌二醇(2-MeOE 2)、16α-羟雌酮(16α-OHE 1)的水平。结果在对照组妇女中,肥胖组E 2、E 1、E 2/2-MeOE 2、E 1/16α-OHE 1明显高于非肥胖组(P<0.05);在肥胖绝经前妇女和非肥胖绝经前妇女中,非典型性增生组患者E 2、4-OHE 2、E 1、16α-OHE 1、E 2/2-MeOE 2、4-OHE 2/2-MeOE 2、E 1/16α-OHE 1在明显高于不伴非典型增生组及对照组(P<0.05);非典型性增生组患者2-MeOE 2、E 2/E 1明显低于不伴非典型性增生组及对照组(P<0.05)。多因素logistics回归分析结果显示,16α-OHE 1是发生子宫内膜非典型增生的独立危险因素(P<0.05)。结论E 2及其代谢产物在子宫内膜非典型增生中异常表达,监测16α-OHE 1水平对于子宫内膜非典型增生的诊断具有一定的价值。Objective To study the relationship between the changes of estrogen and its metabolites with the occurrence of endometrial atypical hyperplasia.Methods Seventy patients with endometrial atypical hyperplasia[the atypical hyperplasia group,which was further divided into the non-obesity group(39 cases)and the obesity group(31 cases)]and the 80 patients with endometrial without complicating atypical hyperplasia[the non-atypical hyperplasia group,which was further divided into the non-obesity group(45 cases)and obesity group(35 cases)]admitted and treated in the Forth Hospital of Hebei Medical University from January 2019 to January 2020 served as the observation group,and 60 healthy premenopausal women undergoing physical examination in the same period were selected as control group[which was further divided into the non-obesity group(30 cases)and the obesity group(30 cases)].The preoperative serum specimens were taken.The ultra performance liquid chromatography-mass spectrometry(UPLC-MS)was used to detect the levels of serum estrogen(E 2)and its metabolites 4-OHE 2,E 1,2-MeOE and 16α-OHE 1.Results In the premenopausal women of the control group,the levels of E 2,E 1,E 2/2-MeOE 2 and E 1/16α-OHE 1 in the obese group were significantly higher than those in the non-obese group(P<0.05).In the obese premenopausal and the non-obese premenopausal women,the levels of E 2,4-OHE 2,E 1,16α-OHE 1,E 2/2-MeOE 2,4-OHE 2/2-MeOE 2 and E 1/16α-OHE 1 in the atypical hyperplasia group were significantly higher than those in the non-atypical hyperplasia group and the control group(P<0.05);the levels of 2-MeOE 2 and E 2/E 1 in the atypical hyperplasia group were significantly lower than those in the non-atypical hyperplasia group and the control group(P<0.05).The multivariate logistic regression analysis results showed that 16α-OHE 1 was an independent risk factor for endometrial atypical hyperplasia(P<0.05).Conclusion The levels of E 2 and its metabolites in endometrial atypical hyperplasia are abnormally expressed.Monitoring the 1

关 键 词：雌二醇 雌酮 4-羟雌二醇 2-甲氧雌二醇 16α-羟基雌酮 子宫内膜非典型性增生 肥胖 血清 

分 类 号：R737.33[医药卫生—肿瘤]