宫腔镜Ⅱ型黏膜下肌瘤切除标本中ARE、Nrf2、JNK表达及与术后复发的关联性探究  

Exploration of anti-oxidation reaction element,nuclear factor E2-related factor and c-Jun amino-terminal kinase expressions in type Ⅱ submucosal myoma samples from hysteroscopic resection and their correlation with postoperative recurrence

作　　者：赵盼 安书杰 ZHAO Pan;AN Shujie(Department of Comprehensive Diagnosis and Treatment,First Affiliated Hospital of Air Force Medical University,Xi′an 710032,Shaanxi,China)

机构地区：[1]空军军医大学第一附属医院综合诊疗科,西安710032

出　　处：《中国性科学》2025年第4期62-66,共5页Chinese Journal of Human Sexuality

基　　金：陕西省重点研发计划项目(2023-YBSF-628)。

摘　　要：目的分析宫腔镜Ⅱ型黏膜下肌瘤切除标本中抗氧化反应元件(ARE)、核因子E2相关因子(Nrf2)、c-Jun氨基末端激酶(JNK)表达及与术后复发的关联性。方法回顾性选取2019年6月至2022年1月于空军军医大学第一附属医院接受宫腔镜Ⅱ型黏膜下肌瘤切除术的302例患者作为病例组,另选取同期因宫颈上皮内瘤变(CIN)Ⅲ级行子宫切除术的100例患者作为对照组,采集两组切除标本,利用Western blot法测定标本中ARE、Nrf2、JNK蛋白表达。病例组术后随访24个月,分析ARE、Nrf2、JNK与术后复发的关系。结果病例组标本ARE、Nrf2蛋白表达低于对照组,JNK蛋白表达高于对照组(P<0.05);复发组标本ARE、Nrf2蛋白表达低于未复发组,JNK蛋白表达高于未复发组(P<0.05);JNK蛋白高表达是独立危险因素(P<0.05),ARE蛋白高表达、Nrf2蛋白高表达是独立保护因素(P<0.05);绘制受试者工作特征(ROC)曲线发现,ARE、Nrf2、JNK蛋白表达及三项联合预测复发的AUC为0.884、0.792、0.801、0.944。结论Ⅱ型黏膜下肌瘤患者ARE、Nrf2蛋白呈低表达,JNK蛋白呈高表达,三者异常表达可增加宫腔镜Ⅱ型黏膜下肌瘤切除术后复发风险,且三者联合可有效预测术后复发。Objective To analyze anti-oxidation reaction element(ARE),nuclear factor E2-related factor(Nrf2)and c-Jun amino-terminal kinase(JNK)expressions in type Ⅱ submucosal myoma samples from hysteroscopic resection and their correlation with postoperative recurrence.Methods A total of 302 patients who underwent hysteroscopic resection of type Ⅱ submucous myoma in First Affiliated Hospital of Air Force Medical University from June 2019 to January 2022 were selected as case group,and another 100 patients who underwent hysterectomy due to cervical intraepithelial neoplasia(CIN) Ⅲ during the same period were selected as control group.The resected samples of the two groups were collected.The expressions of ARE,Nrf2 and JNK proteins in the samples were determined by Western blot.The case group was followed up for 24 months,and the relationship between ARE,Nrf2 and JNK and the postoperative recurrence was analyzed.Results The expressions of ARE,Nrf2 protein in the case group were lower than those in the control group,and the expression of JNK protein was higher than that in the control group(P<0.05).The expressions of ARE and Nrf2 protein in the recurrent group were lower than those in the non-recurrent group,and the expression of JNK protein was higher than that in the non-recurrent group(P<0.05).High expression of JNK protein was an independent risk factor(P<0.05),while high expressions of ARE protein and Nrf2 protein were independent protective factors(P<0.05).The receiver operator characteristic(ROC)curve showed that the area under curve(AUC)of ARE,Nrf2,JNK protein expressions and their combined prediction of recurrence were 0.884,0.792,0.801 and 0.944.Conclusions The patients with type Ⅱ submucosal myoma have low expressions of ARE,Nrf2 protein and high expression of JNK protein.The abnormal expressions of these three proteins can increase the risk of recurrence after hysteroscopic resection of type Ⅱ submucosal myoma,and the combination of the three can effectively predict postoperative recurrence.

关 键 词：Ⅱ型黏膜下肌瘤 宫腔镜切除术 抗氧化反应元件 核因子E2相关因子 C-JUN氨基末端激酶 复发 

分 类 号：R711[医药卫生—妇产科学]