炎症、凝血指标及CA125与子宫内膜异位症的相关性研究进展
Research Progress on the Correlation of Inflammation, Coagulation Markers, and CA125 with Endometriosis
DOI: 10.12677/acm.2024.14123193, PDF,   
作者: 王 恬, 向慧珍*：吉首大学医学院，湖南 吉首；吉首大学第四临床学院，湖南 怀化；黄大元：吉首大学医学院，湖南 吉首
关键词: 子宫内膜异位症；炎症；凝血；CA125；Endometriosis； Inflammation； Coagulation； CA125
摘要: 子宫内膜异位症(Endometriosis, EMs)，简称内异症，指子宫内膜细胞(含腺体和间质)在子宫外区域的生长。EMs最常见的临床症状包括慢性盆腔痛、深部性交痛及不孕，影响了大约10%育龄期妇女，部分EMs患者早期无明显临床症状，因此，EMs的真正患病率尚不能确定，且EMS的临床表现与盆腔恶性肿瘤相似，早期难以通过影像学诊断发现，缺乏可靠、安全的无创诊断及监测病情变化的敏感指标。故寻求一种特异度、灵敏度均较高、无创伤的血清指标应用于EMS早期诊断是当前临床高度关注的内容，本文旨在探讨炎症、凝血、CA125等因素与子宫内膜异位症发病机制的相关性，深化对该疾病病理生理过程的理解，并剖析炎症指标、凝血指标及CA125水平与疾病进展的关联及其诊断意义，为未来临床研究与个性化治疗策略的制定提供理论支撑。
Abstract: Endometriosis (EMs), also known as endometriosis, refers to the growth of endometrial cells (including glands and stroma) in extrauterine regions. The most common clinical symptoms of EMs include chronic pelvic pain, deep dyspareunia, and infertility, affecting approximately 10% of women of reproductive age. Some patients with EMs have no obvious clinical symptoms in the early stages, so the true prevalence of EMs is not yet fully determined. Moreover, the clinical manifestations of EMS are similar to those of pelvic malignant tumors, making early detection through imaging difficult, and there are currently no reliable, safe non-invasive diagnostic and sensitive markers for monitoring disease progression. Therefore, there is a high clinical focus on seeking a serum marker with both high specificity and sensitivity for the early diagnosis of EMS. This article aims to explore the correlation of factors such as inflammation, coagulation, and CA125 with the pathogenesis of endometriosis, deepen the understanding of the pathophysiological processes of the disease, and analyze the association of inflammatory markers, coagulation markers, and CA125 levels with disease progression and their diagnostic significance, providing theoretical support for future clinical research and the formulation of personalized treatment strategies.
文章引用：王恬, 黄大元, 向慧珍. 炎症、凝血指标及CA125与子宫内膜异位症的相关性研究进展[J]. 临床医学进展, 2024, 14(12): 1112-1119. https://doi.org/10.12677/acm.2024.14123193

参考文献

[1] 中国医师协会妇产科医师分会, 中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症诊治指南(第三版) [J]. 中华妇产科杂志, 2021, 56(12): 812-824.
[2] 沈雪, 汪沙, 段华. 第四届全球子宫内膜异位症及子宫疾病协会年会侧记[J]. 中华妇产科杂志, 2018, 53(9): 654-656.
[3] Bg, P., Ee, L., Di, L., et al. (2018) Pathogenesis of Endometriosis: Interaction between Endocrine and Inflammatory Path-Ways. Best Practice & Research Clinical Obstetrics & Gynaecology, 50, 50-60.
[4] Nilufer, R., Sally, M., Marzieh, G., et al. (2023) The Genetic Basis of Endometriosis and Comorbidity with Other Pain and Inflammatory Conditions. Nature Genetics, 55, 423-436.
[5] Widhusadi, N.L.W.A. and Anantasika, A.A.N. (2023) The Role of Epigenetics in Endometriosis. Journal of South Asian Federation of Obstetrics and Gynaecology, 15, 88-96. [Google Scholar] [CrossRef] 
[6] Kiesel, L. and Sourouni, M. (2019) Diagnosis of Endometriosis in the 21st Century. Climacteric, 22, 296-302. [Google Scholar] [CrossRef] [PubMed]
[7] Sachin, R., Amardeep, S., Neema, A., et al. (2024) Endometriosis: A Comprehensive Exploration of Inflammatory Mechanisms and Fertility Implications. Cureus, 16, e66128.
[8] Gleason, J.L., Thoma, M.E., Zukerman Willinger, N. and Shenassa, E.D. (2022) Endometriosis and Uterine Fibroids and Their Associations with Elevated C-Reactive Protein and Leukocyte Telomere Length among a Representative Sample of U.S. Women: Data from the National Health and Nutrition Examination Survey, 1999-2002. Journal of Women’s Health, 31, 1020-1028. [Google Scholar] [CrossRef] [PubMed]
[9] Kaya Sezginer, E., Kirlangiç, Ö.F., Eşkin Tanriverdi, M.D., Topçu, H.O. and Gür, S. (2022) Analysis of Changes in Serum Levels and Gene Expression Profiles of Novel Adipocytokines (Omentin, Vaspin, Irisin and Visfatin) and Their Correlation with Serum C-Reactive Protein Levels in Women Diagnosed with Endometriosis. Turkish Journal of Pharmaceutical Sciences, 19, 48-53. [Google Scholar] [CrossRef] [PubMed]
[10] Guney, G., Taskin, M.I., Laganà, A.S., Tolu, E., Aslan, F., Hismiogullari, A.A., et al. (2023) Neutrophil Gelatinase-Associated Lipocalin Serum Level: A Potential Noninvasive Biomarker of Endometriosis? Medicine, 102, e35539. [Google Scholar] [CrossRef] [PubMed]
[11] Topdagi Yilmaz, E.P., Topdagi, Y.E., Al, R.A. and Kumtepe, Y. (2020) The Relationship between C-Reactive Protein, Carbohydrate Antigen 125, and Hematological Parameters to Endometriotic Nodule Localization in Pelvis. Journal of the Chinese Medical Association, 83, 577-581. [Google Scholar] [CrossRef] [PubMed]
[12] Ecem Kaya, S., Merve Didem Eşkin, T., Gür, S., et al. (2021) Analysis of Changes in Serum Levels and Gene Expression Profiles of Novel Adipocytokines (Omentin, Vaspin, Irisin and Visfatin) and Their Correlation with Serum C-Reactive Protein Levels in Women Diagnosed with Endometriosis. Turkish Journal of Pharmaceutical Sciences, 19, 48-53.
[13] Kaseki, H., Ichikawa, M., Toyoshima, M., Matsuda, S., Nakao, K., Watanabe, K., et al. (2023) Risk Factors for Abscess Development in Patients with Endometrioma Who Present with an Acute Abdomen. Gynecology and Minimally Invasive Therapy, 12, 26-31. [Google Scholar] [CrossRef] [PubMed]
[14] Machairiotis, N., Vasilakaki, S. and Thomakos, N. (2021) Inflammatory Mediators and Pain in Endometriosis: A Systematic Review. Biomedicines, 9, Article 54. [Google Scholar] [CrossRef] [PubMed]
[15] Hou, Z., Zhou, J., Ma, X., Fan, L., Liao, L. and Liu, J. (2008) Role of Interleukin-1 Receptor Type II in the Pathogenesis of Endometriosis. Fertility and Sterility, 89, 42-51. [Google Scholar] [CrossRef] [PubMed]
[16] Marta, S.K., Dominika, W., Andrzej, W., et al. (2024) The Role of Selected Cytokines from the Interleukin-1 Family in the Peritoneal Fluid of Women with Endometriosis. Ginekologia Polska.
[17] Incognito, G.G., Di Guardo, F., Gulino, F.A., et al. (2023) Interleukin-6 as A Useful Predictor of Endometriosis-Associated Infertility: A Systematic Review. International Journal of Fertility and Sterility, 17, 226-230.
[18] Rafał, W., Eva, S., Gerda, H., et al. (2024) Association of Four Interleukin-8 Polymorphisms (−251 A > T, +781 C > T, +1633 C > T, +2767 A > T) with Ovarian Cancer Risk: Focus on Menopausal Status and Endometriosis-Related Subtypes. Biomedicines, 12, Article 321.
[19] Federica, G., Dafne, B., Andrew, T.L., et al. (2024) Evolutionary Analysis of the Mammalian IL-17 Cytokine Family Suggests Conserved Roles in Female Fertility. American Journal of Reproductive Immunology, 92, e13907.
[20] Li, Y., Zhou, Z., Liang, X., Ding, J., He, Y., Sun, S., et al. (2024) Gut Microbiota Disorder Contributes to the Production of IL-17A That Exerts Chemotaxis via Binding to IL-17RA in Endometriosis. Journal of Inflammation Research, 17, 4199-4217. [Google Scholar] [CrossRef] [PubMed]
[21] Ruan, J.Y., Tian, Q., Li, S.T., et al. (2024) The IL-33-ST2 Axis Plays a Vital Role in Endometriosis via Promoting Epithelial-Mesenchymal Transition by Phosphorylating β-Catenin. Cell Communication and Signaling, 22, Article No. 318.
[22] Lin, T., Wang, K., Chuang, K., Kao, A. and Kuo, T. (2024) Celecoxib Attenuates Interleukin 33-Induced Expression of Vascular Cell Adhesion Molecule-1 in Human Ovarian Endometriotic Stromal Cells. 63, 178-185. [Google Scholar] [CrossRef] [PubMed]
[23] Zhang, J., Zhao, W., Zhou, Y., Xi, S., Xu, X., Du, X., et al. (2024) Pyroptotic T Cell-Derived Active IL-16 Has a Driving Function in Ovarian Endometriosis Development. Cell Reports Medicine, 5, Article ID: 101476. [Google Scholar] [CrossRef] [PubMed]
[24] Sadat Sandoghsaz, R., Montazeri, F., Shafienia, H., Mehdi Kalantar, S., Javaheri, A. and Samadi, M. (2024) Expression of Mir-21 & IL-4 in Endometriosis. Human Immunology, 85, Article ID: 110746. [Google Scholar] [CrossRef] [PubMed]
[25] Dominoni, M., Pasquali, M.F., Musacchi, V., De Silvestri, A., Mauri, M., Ferretti, V.V., et al. (2024) Neutrophil to Lymphocytes Ratio in Deep Infiltrating Endometriosis as a New Toll for Clinical Management. Scientific Reports, 14, Article No. 7575. [Google Scholar] [CrossRef] [PubMed]
[26] Ozgu-Erdinc, A.S., Coskun, B., Yorganci, A., Hancerliogullari, N., Yilmaz, N. and Engin-Ustun, Y. (2020) The Role of Inflammatory Hematological Markers in Predicting IVF Success. JBRA Assisted Reproduction, 25, 71-75. [Google Scholar] [CrossRef] [PubMed]
[27] Cho, H., Park, S. and Park, S. (2022) Red Blood Cell Indices as an Effective Marker for the Existence and Severity of Endometriosis (Strobe). Medicine, 101, e31157. [Google Scholar] [CrossRef] [PubMed]
[28] Li, M.M., Tang, X.H., Wang, L.M., et al. (2023) [Study on the Predictive Significance of PLR, SII and RPR in Ovarian Endometriotic Cyst]. Chinese Journal of Obstetrics and Gynecology, 58, 672-679.
[29] Rottenstreich, A., Kalish, Y., Gilan, A., Spectre, G., Kleinstern, G. and Dior, U. (2023) The Procoagulant Potential before and after Surgery for Endometriosis and Its Association with Disease Severity. Blood Coagulation & Fibrinolysis, 34, 305-309. [Google Scholar] [CrossRef] [PubMed]
[30] Zheng, S., Chen, X., Chen, Y., Wu, Z., Chen, X. and Li, X. (2023) Antioxidant Vitamins Supplementation Reduce Endometriosis Related Pelvic Pain in Humans: A Systematic Review and Meta-Analysis. Reproductive Biology and Endocrinology, 21, Article No. 79. [Google Scholar] [CrossRef] [PubMed]
[31] Yu, Q., Chen, L., Wang, J., Xu, X., Li, T., Guo, X., et al. (2023) Investigation of the Therapeutic Effect of Salbutamol on Endometriosis in a Mouse Model. Reproductive Sciences, 31, 430-440. [Google Scholar] [CrossRef] [PubMed]
[32] Wang, L., Ling, J., Zhu, X., Zhang, Y., Li, R., Huang, J., et al. (2024) The Coagulation Status in Women of Endometriosis with Stage Iv. BMC Women’s Health, 24, Article No. 386. [Google Scholar] [CrossRef] [PubMed]
[33] Carrillo Torres, P., Martínez-Zamora, M.Á., Tàssies, D., Castillo, H., Gracia, M., Feixas, G., et al. (2023) Impact of Continuous Estroprogestin Treatment on Circulating Microparticle Levels in Deep Endometriosis Patients. International Journal of Molecular Sciences, 24, Article 11802. [Google Scholar] [CrossRef] [PubMed]
[34] Gong, Z., Li, Q., Li, J., Xie, J. and Wang, W. (2022) A Novel Signature Based on Autophagy-Related LncRNA for Prognostic Prediction and Candidate Drugs for Lung Adenocarcinoma. Translational Cancer Research, 11, 14-28. [Google Scholar] [CrossRef] [PubMed]
[35] Li, Y., Liu, H.Y., Ye, S.T., et al. (2023) The Effects of Coagulation Factors on the Risk of Endometriosis: A Mendelian Randomization Study. BMC Medicine, 21, Article No. 195.
[36] Casalechi, M., Tripodi, A., Reis, F.M., Carullo, G., Mondini, I., Di Stefano, G., et al. (2023) The Link between Inflammation and Hemostasis in Endometriosis: A Call for Research. Journal of Endometriosis and Uterine Disorders, 3, Article ID: 100040. [Google Scholar] [CrossRef] 
[37] Sasamoto, N., DePari, M., Vitonis, A.F., Laufer, M.R., Missmer, S.A., Shafrir, A.L., et al. (2020) Evaluation of CA125 in Relation to Pain Symptoms among Adolescents and Young Adult Women with and without Surgically-Confirmed Endometriosis. PLOS ONE, 15, e0238043. [Google Scholar] [CrossRef] [PubMed]
[38] Sun, J.F., Wang, X.L., Yu, W.N., et al. (2024) [Efficacy and Safety of Dienogest on Ovarian Endometrioma]. Chinese Journal of Obstetrics and Gynecology, 59, 692-701.
[39] Rao, Y.Y., Chen, M. and Li, Y.J. (2024) A New Treatment for Robert’s Uterus with Adenomyosis: A Case Report and Review of the Literature. BMC Women’s Health, 24, Article No. 450.
[40] Herranz-Blanco, B., Daoud, E., Viganò, P., García-Velasco, J.A. and Colli, E. (2023) Development and Validation of an Endometriosis Diagnostic Method Based on Serum Biomarkers and Clinical Variables. Biomolecules, 13, Article 1052. [Google Scholar] [CrossRef] [PubMed]
[41] Daoud, E., Archer, D.F., Parazzini, F. and Herranz-Blanco, B. (2024) Validation of an in Vitro Diagnostic Test for Endometriosis: Impact of Confounding Medical Conditions and Lesion Location. International Journal of Molecular Sciences, 25, Article 7667. [Google Scholar] [CrossRef] [PubMed]
[42] Bárbara, H.B., Elza, D., Paola, V., et al. (2023) Development and Validation of an Endometriosis Diagnostic Method Based on Serum Biomarkers and Clinical Variables. Biomolecules, 13, Article 1052.

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