子宫内膜异位患者CXCL16的表达情况及诊断价值

陈惠娴 张真真 万贵平

[摘要] 目的 探討血清中人CXC型趋化因子配体16（CXCL16）对子宫内膜异位症的诊断价值。 方法 选取2016年1月～2017年12月，在江苏省中西医结合医院妇科住院行腹腔镜手术的47例患者，其中27例子宫内膜异位症患者及20例无子宫内膜异位症患者。分别测定患者的血清CXCL16水平，进行统计学分析，并绘制受试者工作特征曲线（ROC曲线），评价其对子宫内膜异位症的诊断价值。 结果 子宫内膜异位症患者的血清CXCL16水平明显高于无子宫内膜异位症患者，差异有统计学意义（P < 0.05）；不同月经分期（卵泡期、排卵期、黄体期）的子宫内膜异位症患者间CXCL16的表达水平比较，差异无统计学意义（P > 0.05）。Ⅲ、Ⅳ期子宫内膜异位症患者的血清CXCL16水平显著低于Ⅰ期患者（P < 0.05），且与Ⅱ期患者比较差异无统计学意义（P > 0.05）。ROC曲线分析显示ROC曲线下的面积为0.768，CI：0.63～0.905，特异性和敏感性总和最高的截断值为0.9750，特异性为50%，灵敏度为96.3%。 结论 血清CXCL16是一种有价值的生物标志物，可为子宫内膜异位症提供一种简单的非侵入性诊断方法。

[关键词] 子宫内膜异位症；人CXC型趋化因子配体16；白介素-8；黏附分子

[中图分类号] R711.71 [文献标识码] A [文章编号] 1673-7210（2018）05（c）-0092-04

The expression and diagnostic value of CXCL16 in patients with endometriosis

CHEN Huixian1 ZHANG Zhenzhen2 WAN Guiping2▲

1.The Third Clinical Medicine， Nanjing University of Chinese Medicine， Jiangsu Province， Nanjing 210046； 2.Department of Gynaecology and Obstetrics， Affiliated Hospital of Integrated Traditional Chinese and Western Medicine， Nanjing University of Chinese Medicine， Jiangsu Province， Nanjing 210028

[Abstract] Objective To investigate the diagnostic value of human CXC chemokine ligand 16 （CXCL16） in the diagnosis of endometriosis. Methods Forty-seven patients who underwent laparoscopic surgery from January 2016 to December 2017 in Affiliated Hospital of Integrated Traditional Chinese and Western Medicine， Nanjing University of Chinese Medicine were selected， and were divided into observation group with endometriosis （27 cases） and control group without endometriosis （20 cases）. All the levels of serum CXCL16 were tested and the receiver operating characteristic curve （ROC curve） was drawn in order to evaluate the diagnostic value. Results The serum CXCL16 levels in observation group were significantly higher than those in control group， the difference was statistically significant （P < 0.05）. Patients with different menstrual stages （follicular phase， ovulation phase， luteal phase） was found had no statistically significant difference （P > 0.05）. The CXCL16 leves of patients in stage Ⅲ and Ⅳ endometriosis were significantly lower than that in stage Ⅰ （P < 0.05）， and had no statistical difference with stage stage Ⅱ patients （P > 0.05）. The ROC curve analysis showed that the area under the ROC curve was 0.768， CI：0.63-0.905， and the cutoff value of the highest total of specificity and sensitivity was 0.9750， specificity was 50% and sensitivity was 96.3%. Conclusion The serum CXCL16 is a valuable biomarker and it may provide a simple， non-invasive tool for the diagnosis of endometriosis.

[Key words] Endometriosis； Human CXC chemokine ligand 16； IL-8； CAM

子宫内膜异位症是一种妇科常见疾病，特征在于功能性的子宫内膜出现在卵巢、宫底韧带、腹膜和子宫直肠凹等子宫体以外的部位。其主要临床表现包括痛经、慢性盆腔痛、性交困难、不孕等[1]，在生育期的女性中发病率为6%～10%[2]，在不孕症患者中的发病率甚至高达35%[3]，且呈逐年升高的趋势，成为严重影响育龄女性健康的良性疾病之一。目前临床诊断子宫内膜异位症的金标准是腹腔镜检查[4]，然而，这种侵入性的诊断方法会带来与手术相关的风险，且会导致平均10年的诊断延迟[5]。……