MUM1在反复种植失败患者子宫内膜中的表达及对其慢性子宫内膜炎的诊断价值  

Expression of MUM1 in endometrium of patients with recurrent implantation failure and its diagnostic value in chronic endometritis

作　　者：李西雅 赵冬梅[1] 王亚芹 谭丽[1] 张洁[1] 吴会芳[2] Li Xiya;Zhao Dongmei;Wang Yaqin;Tan Li;Zhang Jie;Wu Huifang(Reproductive Medicine Centre of the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Pathology Department of the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院生殖医学中心,郑州450000 [2]郑州大学第二附属医院病理科,郑州450000

出　　处：《中华生殖与避孕杂志》2023年第1期73-77,共5页Chinese Journal of Reproduction and Contraception

基　　金：河南省科技厅科技攻关项目(212102310467)。

摘　　要：目的探讨多发性骨髓瘤癌基因1(multiple myeloma oncogene l,MUM1)在反复种植失败(recurrent implantation failure,RIF)患者子宫内膜中的表达及其对慢性子宫内膜炎(chronic endometritis,CE)的诊断价值。方法采用队列研究收集2019年10月至2021年10月期间在郑州大学第二附属医院生殖医学中心就诊的RIF患者资料112例。患者均行宫腔镜检查,取子宫内膜组织,采用免疫组织化学染色法检测子宫内膜组织MUM1、CD138阳性表达情况,比较子宫内膜MUM1和CD138阳性表达率;采用Kappa检验比较宫腔镜检查联合MUM1与联合CD138免疫组织化学染色诊断CE的一致性;采用四格表法比较MUM1和CD138诊断CE的灵敏度。结果112例RIF患者宫腔镜检查诊断CE共55例,检出率为49.11%。子宫内膜MUM1阳性表达率高于CD138[52.68%(59/112)比41.07%(46/112),P<0.001];宫腔镜检查联合MUM1与联合CD138免疫组织化学染色诊断CE的Kappa值为0.794;子宫内膜MUM1免疫组织化学染色诊断CE的灵敏度及阴性预测值均高于CD138[分别为100%(59/59)比77.97%(46/59)和100%(53/53)比80.31%(53/66),均P<0.001]。结论对RIF患者,宫腔镜检查联合子宫内膜MUM1免疫组织化学染色可作为一种更精准的诊断CE方法。Objective To investigate the expression of multiple myeloma oncogene 1(MUM1)in patients with recurrent implantation failure(RIF)and its diagnostic value in chronic endometritis(CE).Methods The data of 112 patients with RIF treated in the Reproductive Medicine Centre of the Second Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were collected by cohort study.All patients underwent hysteroscopy,endometrial tissue was collected and the positive expressions of MUM1 and CD138 in endometrial tissue were detected by immunohistochemistry staining;the differences in the positive expression rates of MUM1 and CD138 in endometrium were compared;the consistency of hysteroscopy combined with MUM1 and combined with CD138 immunohistochemistry staining in the diagnosis of CE was compared by Kappa test;the sensitivity of MUM1 and CD138 in diagnosing CE was compared by four-tabular method.Results There were 55 cases of CE diagnosed by hysteroscopy in 112 patients with RIF,and the incidence was 49.11%.The positive expression rate of MUM1 was higher than that of CD138[52.68%(59/112)vs.41.07%(46/112),P<0.001]in endometrium of 112 RIF patients;the Kappa value of hysteroscopy combined with MUM1 and combined with CD138 immunohistochemistry staining in the diagnosis of CE was 0.794;the sensitivity and negative predictive value of endometrial MUM1 immunohistochemistry staining in the diagnosis of CE were higher than those of CD138[100%(59/59)vs.77.97%(46/59)and 100%(53/53)vs.80.31%(53/66),all P<0.001].Conclusion In patients with RIF,hysteroscopy combined with endometrial MUM1 immunohistochemistry staining can be used as a more accurate method for diagnosing CE.

关 键 词：多发性骨髓瘤癌基因1 反复种植失败 慢性子宫内膜炎 子宫内膜 免疫组织化学染色 诊断价值 

分 类 号：R714.8[医药卫生—妇产科学]