血清CCL18、sB7-H3水平对子宫内膜异位症的诊断价值  

Diagnostic value of serum CCL18 and sB7-H3 levels in endometriosis

作　　者：孙晓华 宋雨霖 李红 刘秀梅 钱荣华 SUN Xiaohua;SONG Yulin;LI Hong;LIU Xiumei;QIAN Ronghua(Department of Gynecology,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao,Hebei 066000,China;Department of Obstetrics,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao,Hebei 066000,China;Department of Gynecologic Oncology,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao,Hebei 066000,China)

机构地区：[1]河北省秦皇岛市妇幼保健院妇科,河北秦皇岛066000 [2]河北省秦皇岛市妇幼保健院产科,河北秦皇岛066000 [3]河北省秦皇岛市妇幼保健院妇瘤科,河北秦皇岛066000

出　　处：《检验医学与临床》2024年第20期2965-2969,共5页Laboratory Medicine and Clinic

基　　金：河北省秦皇岛市科学技术局市级科学技术研究与发展计划自筹经费项目(202301A214)。

摘　　要：目的观察子宫内膜异位症(EMs)患者血清趋化因子18(CCL18)、共刺激分子可溶性B7-H3(sB7-H3)水平,并探讨二者对EMs的诊断价值。方法选取2022年5月至2023年9月在该院就诊的97例EMs患者作为EMs组。根据EMs分期标准将97例EMs患者分为Ⅰ~Ⅱ期组和Ⅲ~Ⅳ期组;根据视觉模拟评分法将97例EMs患者按照痛经严重程度分为轻度组、中度组和重度组。另选取同期于该院进行健康体检的91例健康者作为对照组。收集所有研究对象的临床资料,包括年龄、体质量指数(BMI)、孕次、产次、糖类抗原125(CA125)、抗子宫内膜抗体(EMAb)、雌二醇、孕酮及促卵泡激素(FSH)水平等。采用酶联免疫吸附试验检测血清CCL18、sB7-H3水平。采用多因素Logistic回归分析发生EMs的危险因素。绘制受试者工作特征(ROC)曲线分析血清CCL18、sB7-H3单独及联合检测对EMs的诊断价值。结果EMs组血清CCL18、sB7-H3水平均显著高于对照组,差异均有统计学意义(P<0.05)。Ⅰ~Ⅱ期组纳入41例患者,Ⅲ~Ⅳ期组纳入56例患者。与Ⅰ~Ⅱ期组相比,Ⅲ~Ⅳ期组患者血清CCL18、sB7-H3水平显著升高,差异有统计学意义(P<0.05)。轻度组纳入35例患者,中度组纳入39例患者,重度组纳入23例患者。不同痛经程度患者血清CCL18、sB7-H3水平比较,差异均有统计学意义(P<0.05);与轻度组相比,中度组和重度组血清CCL18、sB7-H3水平显著上升,差异有统计学意义(P<0.05);与中度组相比,重度组血清CCL18、sB7-H3水平显著上升,差异有统计学意义(P<0.05)。与对照组相比,EMs组血清CA125、EMAb水平显著升高,雌二醇、FSH水平均显著降低,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高水平CCL18及高水平sB7-H3是EMs发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清CCL18、sB7-H3单独及联合检测诊断EMs的曲线下面积(AUC)分别为0.759、0.798和0.882,血清CCL18、sB7-H3联合检测对EMs的诊断�Objective To observe the levels of serum chemokine 18(CCL18)and costimulatory molecule soluble B7-H3(sB7-H3)in patients with endometriosis(EMs)and to explore the diagnostic value of CCL18 and SB7-H3 in EMs.Methods A total of 97 EMs patients treated at this hospital from May 2022 to September 2023 were selected as the EMs group.According to the EMs staging criteria,97 EMs patients were divided into stageⅠ-Ⅱgroup and stageⅢ-Ⅳgroup.According to the visual analogue scale,97 EMs patients were divided into mild group,moderate group and severe group according to the severity of dysmenorrhea.In addition,91 healthy people who underwent physical examination in this hospital during the same period were selected as the control group.The clinical data of all subjects were collected,including age,body mass index(BMI),gravidity,parity,carbohydrate antigen 125(CA125),anti-endometrial antibody(EMAb),estradiol,progesterone and follicle stimulating hormone(FSH)levels.The serum levels of CCL18 and sB7-H3 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the risk factors of EMs.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum CCL18 and sB7-H3 alone and in combination for EMs.Results The serum levels of CCL18 and sB7-H3 in EMs group were significantly higher than those in control group(P<0.05).There were 41 patients in the stageⅠ-Ⅱgroup and 56 patients in the stageⅢ-Ⅳgroup.Compared with the stageⅠ-Ⅱgroup,the levels of serum CCL18 and sB7-H3 in the stageⅢ-Ⅳgroup were significantly increased(P<0.05).Thirty-five patients were included in the mild group,39 patients in the moderate group,and 23 patients in the severe group.There were significant differences in serum CCL18 and sB7-H3 levels between patients with different dysmenorrhea degrees(P<0.05).Compared with the mild group,the serum CCL18 and sB7-H3 levels in the moderate group and severe group were significantly increased,and the difference was statistically

关 键 词：子宫内膜异位症 趋化因子18 共刺激分子可溶性B7-H3 诊断价值 严重程度 

分 类 号：R711.71[医药卫生—妇产科学] R446.6[医药卫生—临床医学]