MUM-1、CD138、CD38对慢性子宫内膜炎的诊断价值及其与生殖预后的关系  

Diagnostic value of MUM-1,CD138 and CD38 in chronic endometritis and their relationship with reproductive prognosis

作　　者：姜玉婵 赵静 李敏 徐小飞[3] JIANG Yuchan;ZHAO Jing;LI Min;XU Xiaofei(Department of Reproductive Health,the Second Maternal and Child Health Hospital of Jinan,Jinan,Shandong 271199,China;Department of Pathology,the Second Maternal and Child Health Hospital of Jinan,Jinan,Shandong 271199,China;Center for Reproductive Medicine,Qilu Hospital of Shandong University,Jinan,Shandong 250012,China)

机构地区：[1]山东省济南市第二妇幼保健院生殖健康科,山东济南271199 [2]山东省济南市第二妇幼保健院病理科,山东济南271199 [3]山东大学齐鲁医院生殖医学中心,山东济南250012

出　　处：《检验医学与临床》2024年第11期1562-1567,共6页Laboratory Medicine and Clinic

基　　金：山东省济南市卫生健康委员会科技发展计划项目(2020-4-157)。

摘　　要：目的分析多发性骨髓瘤癌基因-1(MUM-1)、白细胞分化抗原(CD)138、CD38在对慢性子宫内膜炎(CE)中的诊断价值及其与生殖预后的关系。方法选取2018年1月至2021年12月因不孕症于山东省济南市第二妇幼保健院生殖健康科就诊,并在山东大学齐鲁医院生殖医学中心接受体外受精-胚胎移植(IVF-ET)的194例患者作为研究对象。所有研究对象术前均接受宫腔镜检查,记录宫腔情况,取子宫内膜组织进行MUM-1、CD138、CD38标志物免疫组织化学染色及子宫内膜活检,并将子宫内膜苏木精-伊红染色法(HE)染色结果作为金标准,免疫组织化学染色结果与HE染色结果的一致性分析使用Kappa检验,分析免疫组织化学染色MUM-1、CD138、CD38单独及3项指标联合检测对CE的诊断效能。根据生殖预后将194例患者分为失败组和成功组,比较失败组和成功组的临床资料,采用多因素Logistic回归分析IVF-ET失败的危险因素。结果HE染色结果显示,194例接受IVF-ET的患者中90例确诊为CE;MUM-1、CD138、CD38单独及3项指标联合检测的免疫组织化学结果与HE染色结果的一致性分析显示,Kappa值分别为0.475、0.537、0.464、0.752(P<0.05);3项指标联合诊断CE的灵敏度、准确度、阳性预测值均高于MUM-1、CD138、CD38单独诊断,差异均有统计学意义(P<0.05);CD38单独诊断CE的灵敏度高于MUM-1、CD138单独诊断,特异度低于MUM-1、CD138单独诊断,差异均有统计学意义(P<0.05)。194例接受IVF-ET的患者中妊娠失败106例,妊娠成功88例。失败组与成功组年龄、体质量指数、不孕年限、月经经期、月经周期,以及基础内膜厚度、基础促卵泡刺激素、基础雌二醇、基础促黄体生成激素水平比较,差异均无统计学意义(P>0.05);失败组继发性不孕、人工流产次数≥1次、CE、MUM-1阳性、CD138阳性、CD38阳性患者比例均高于成功组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结�Objective To analyze the diagnostic value of multiple myeloma oncogene-1(MUM-1),leukocyte differentiation antigen(CD)138 and CD38 in chronic endometritis(CE)and their relationship with reproductive prognosis.Methods A total of 194 infertile patients who visited the Department of Reproductive Health of the Second Maternal and Child Health Hospital of Jinan due to infertility and underwent in vitro fertilization-embryo transfer(IVF-ET)in the Center for Reproductive Medicine of Qilu Hospital of Shandong University from January 2018 to December 2021 were selected as the research objects.All subjects underwent hysteroscopy before operation,and the uterine cavity conditions were recorded.The endometrial tissues were taken for MUM-1,CD138,CD38 marker immunohistochemical staining and endometrial biopsy,and the results of endometrial hematoxylin-eosin(HE)staining were used as the gold standard.The consistency between the results of immunohistochemical staining and HE staining was analyzed by Kappa test.The diagnostic efficacy of immunohistochemical MUM-1,CD138,CD38 alone and three markers combination in CE was analyzed.According to the reproductive prognosis,the 194 patients were divided into the failure group and the success group.The clinical data of the failure group and the success group were compared,and the risk factors for IVF-ET failure were analyzed by multivariate Logistic regression.Results HE staining showed that 90 of 194 patients were diagnosed as CE.Consistency analysis of immunohistochemical results of MUM-1,CD138,CD38 alone and combined detection of three markers with the results of HR staining showed that Kappa values were 0.475,0.537,0.464,0.752(P<0.05).The sensitivity,accuracy and positive predictive value of the combination of the three markers in the diagnosis of CE were higher than those of MUM-1,CD138 and CD38 alone,and the differences were statistically significant(P<0.05).The sensitivity of CD38 alone in the diagnosis of CE was higher than that of MUM-1 or CD138 alone,and the specificity of CD38

关 键 词：体外受精-胚胎移植 慢性子宫内膜炎 多发性骨髓瘤癌基因-1 白细胞分化抗原138 白细胞分化抗原38 生殖预后 

分 类 号：R711.32[医药卫生—妇产科学] R446.8[医药卫生—临床医学]