子宫腺肌病/卵巢异位囊肿炎性压力及其与临床特征相关性研究

目的：系统探讨子宫腺肌病/卵巢异位囊肿患者外周血炎性指标变化及其与临床特征的相关性,为子宫腺肌病/卵巢异位囊肿抗炎治疗提供依据。方法：选取来自同济大学附属杨浦医院收治的子宫腺肌病手术患者58例（子宫腺肌病组）、卵巢异位囊肿手术患者37例（卵巢异位囊肿组）,健康女性47例（对照组）,于增生期抽取外周血,检测血清炎性细胞因子和肿瘤相关抗原浓度,分析炎性压力与临床特征的相关性。结果：子宫腺肌病组外周血中性粒细胞（Neu）、Neu%、中性粒细胞与淋巴细胞比值（NLR）、白细胞介素6（IL-6）、IL-8、CA199、CA125高于对照组,差异有统计学意义（均P＜0.05）;子宫腺肌病组外周血血红蛋白（HGB）低于对照组,差异有统计学意义（Z=688.50,P=0.00）。卵巢异位囊肿组外周血Neu、Neu%、NLR、IL-6、IL-8、肿瘤坏死因子-α（TNF-α）、CA199和CA125高于对照组,差异有统计学意义（均P＜0.05）。子宫腺肌病中度痛经组外周血白细胞（WBC）、CA125高于轻度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-8和IL-6高于中度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于轻度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病中、重度痛经组外周血HGB低于轻度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病经量过多组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于正常月经组,差异有统计学意义（均P＜0.05）。卵巢异位囊肿重度痛经组外周血IL-6、IL-8高于轻度、中度痛经组,差异有统计学意义（均P＜0.05）。子宫内膜异位症患者肿瘤指标与外周血炎性指标在统计学上无明显相关性。结论：子宫腺肌病/卵巢异位囊肿处于全身炎症压力状态,并与临床特征相关,为子宫内膜异位症抗炎治疗提供了依据。。     

子宫腺肌病/卵巢异位囊肿炎性压力及其与临床特征相关性研究

目的:系统探讨子宫腺肌病/卵巢异位囊肿患者外周血炎性指标变化及其与临床特征的相关性,为子宫腺肌病/卵巢异位囊肿抗炎治疗提供依据。方法:选取来自同济大学附属杨浦医院收治的子宫腺肌病手术患者58例(子宫腺肌病组)、卵巢异位囊肿手术患者37例(卵巢异位囊肿组),健康女性47例(对照组),于增生期抽取外周血,检测血清炎性细胞因子和肿瘤相关抗原浓度,分析炎性压力与临床特征的相关性。结果:子宫腺肌病组外周血中性粒细胞(Neu)、Neu%、中性粒细胞与淋巴细胞比值(NLR)、白细胞介素6(IL-6)、IL-8、CA199、CA125高于对照组,差异有统计学意义(均P0.05);子宫腺肌病组外周血血红蛋白(HGB)低于对照组,差异有统计学意义(Z=688.50,P=0.00)。卵巢异位囊肿组外周血Neu、Neu%、NLR、IL-6、IL-8、肿瘤坏死因子-α(TNF-α)、CA199和CA125高于对照组,差异有统计学意义(均P0.05)。子宫腺肌病中度痛经组外周血白细胞(WBC)、CA125高于轻度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-8和IL-6高于中度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于轻度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病中、重度痛经组外周血HGB低于轻度痛经组,差异有统计学意义(均P0.05)。子宫腺肌病经量过多组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于正常月经组,差异有统计学意义(均P0.05)。卵巢异位囊肿重度痛经组外周血IL-6、IL-8高于轻度、中度痛经组,差异有统计学意义(均P0.05)。子宫内膜异位症患者肿瘤指标与外周血炎性指标在统计学上无明显相关性。结论:子宫腺肌病/卵巢异位囊肿处于全身炎症压力状态,并与临床特征相关,为子宫内膜异位症抗炎治疗提供了依据。     

盆腔良性肿物伴血清CA125水平升高的临床意义

目的探讨血清CA125水平在妇科良性肿瘤、结核性肿物及其他炎症性肿物、子宫内膜异位症等盆腔良性肿物中的升高情况及临床意义.方法回顾性分析中国医学科学院中国协和医科大学肿瘤医院于1999年1月-2003年12月间收治并经病理检查证实的492例妇科盆腔良性肿物患者的临床资料,其中卵巢良性肿瘤237例,其他盆腔良性肿物如子宫肌瘤、子宫腺肌病、卵巢子宫内膜异位症、盆腔结核及其他炎症性肿物等共255例,所有患者术前均有血清CA125的检测.另随机选取60例卵巢上皮性癌患者作为对照.结果盆腔结核、子宫腺肌病、卵巢子宫内膜异位症及卵泡膜-纤维组肿瘤患者的血清CA125水平中位数值均高于正常值(35 kU/L以下),分别是465.0、88.9、59.0、44.5 kU/L.本组盆腔良性肿物中, 血清CA125水平单例最高值为卵泡膜-纤维组肿瘤(1281.0 kU/L),中位数值最高者为盆腔结核(465.0 kU/L).60例卵巢上皮性癌患者血清CA125水平升高者达95.0%,其中位数值是755.5 kU/L,与良性肿物相比,差异有统计学意义(P<0.01 ).在子宫肌瘤与子宫腺肌病的鉴别诊断中,以血清CA125≥50 kU/L为标准,诊断子宫腺肌病的敏感性、特异性、阳性预测值及阴性预测值相对较高,分别是72%、94%、79%和91%.结论血清CA125水平升高也可见于一些盆腔良性肿物,主要有盆腔结核、子宫腺肌病、卵巢子宫内膜异位症及卵泡膜-纤维组肿瘤等,但其中位数值均明显低于卵巢上皮性癌.血清CA125水平检测有利于子宫肌瘤和子宫腺肌病的鉴别诊断.     

血清及腹腔液CA125测定对子宫腺肌病的诊断价值

目的探讨血清及腹腔液CA125测定对子宫腺肌病的诊断价值.方法采用免疫化学发光法测定28例子宫腺肌病和25例子宫肌瘤患者血清及腹腔液(110稀释)CA125水平.结果子宫腺肌病患者血清CA125水平高于子宫肌瘤患者,差异有显著性(P＜0.01).两组间腹腔液CA125水平差异无显著性(P=0.18).腹腔液CA125水平明显高于血清CA125水平(P＜0.01),但二者无明显相关性(P＞0.50).腺肌病患者血清CA125水平受子宫大小、大体病理类型、使用性激素等因素影响.结论如用于子宫腺肌病的辅助诊断,血清CA125测定较腹腔液CA125测定敏感.腹腔液中CA125的主要来源可能为腹膜上皮细胞.     

对子宫腺肌病患者血清CA125及EMAb的临床评价

目的：探讨血清CA125及子宫内膜抗体（EMAb)测定，对子宫腺肌病的诊断及疗效评估的临床价值。方法：经术后病理学检查确诊子宫腺肌病患者63例和子宫肌瘤患者45例，均于术前及术后测定两组血清CA125水平和EMAb。结果：子宫腺肌病组术前血清CA125平均水平及EMAb阳性率均高于子宫肌瘤组，两者相比差异有显著性（P＜0．001及P＜0．01）。联合测定血清CA125水平和EMAb，以两者均阳性为诊断标准，诊断子宫腺肌病的敏感性为54．63％，特异性为100％。子宫腺肌病组术后血清CA125水平和EMAb阳性率均较术前下降，差异有显著性（P＜0．01及P＜0．05）。结论：测定血清CA125及EMAb对子宫腺肌病有较好的辅助诊断价值，联合检测更能提高诊断的正确性，并可作为评价子宫腺肌病疗效的敏感指标。     

子宫内膜细胞增生相关核抗原ki67和CA125在子宫腺肌病组织中的表达

目的 :①通过观察子宫内膜细胞增生相关核抗原ki6 7的表达探讨子宫内膜增殖能力对子宫腺肌病发病的影响。②研究子宫腺肌病患者血清CA12 5升高的来源和意义。方法 :手术切除子宫标本共 5 9例 ,其中子宫腺肌病 (简称 :腺肌病 ) 2 7例 ,子宫肌瘤 (简称 :肌瘤 ) 32例。应用免疫组化方法检测CA12 5、ki6 7在子宫腺肌病和子宫肌瘤患者子宫内膜、腺肌病病灶中的表达。免疫化学发光法测定血清CA12 5水平。结果 :两组在位内膜腺体ki6 7表达强度增生期较分泌期显著增强 ,P <0 .0 5 ,腺肌病组异位内膜ki6 7表达无周期性变化 ,腺肌病组异位内膜腺体ki6 7的表达在分泌期强于其自身在位内膜 ,P <0 .0 5 ,腺肌病组子宫内膜与肌瘤组子宫内膜ki6 7表达无统计学差异。腺肌病组血清CA12 5水平显著高于肌瘤组 ,P <0 .0 0 1,两组血清CA12 5水平增生期与分泌期差异均无显著性。腺肌病组与肌瘤组内膜间及腺肌病组在位内膜与异位内膜腺上皮间CA12 5表达差异无显著性 ,并且均无周期性变化。结论 :①腺肌病异位内膜ki6 7表达增多 ,增生能力较在位内膜增强 ,说明子宫内膜侵入子宫肌层后 ,增殖能力明显增强在疾病的发展中可能有一定作用。②血清CA12 5水平腺肌病组明显高于肌瘤组。     

cccPLT和NLR修正CA125预测子宫腺肌病盆腔致密粘连的临床价值

目的探讨血清CA125、外周血PLT、NLR以及修正CA125预测子宫腺肌病盆腔致密粘连(pelvic dense adhesion,PDA)的临床价值。方法回顾304例腺肌病手术病例资料,采用Logistic回归分析患者CA125、PLT、NLR以及修正CA125与腺肌病PDA的相关性;使用ROC曲线评价其预测腺肌病PDA的价值。结果患者血清CA125、外周血PLT、NLR以及修正CA125与腺肌病PDA均呈正相关(P0.01或P0.05)。与单独使用血清CA125相比,修正CA125a可以提高预测腺肌病PDA的特异度(85.03%vs 83.00%)和敏感度(47.56%vs 47.47%);修正CA125b可以提高其特异度(53.13%vs 47.47%)。结论血清CA25、PLT及NLR与腺肌病患者PDA密切相关;使用PLT、NLR修正CA125能够进一步提高预测腺肌病PDA的准确性,可以为临床医师设计和实施腺肌病手术方式提供参考依据。     

人附睾蛋白4对子宫内膜癌的风险评估研究

目的：探讨血清人附睾蛋白4（HE4）、癌抗原125（CA125）对子宫宫体疾病患者患子宫内膜癌风险的评估价值。方法：采用电化学发光法检测453例子宫肌瘤患者、126例子宫腺肌病患者、26例子宫内膜增生患者、10例子宫内膜息肉患者、212例子宫内膜癌患者以及72例体检正常妇女血清HE4和CA125水平。结果：血清HE4在子宫内膜癌组的表达水平高于其他各组,差异有统计学意义（均P＜0.01）;血清CA125在子宫腺肌病组的表达水平高于其他各组,差异有统计学意义（均P=0.000）;子宫内膜癌患者血清HE4表达水平与国际妇产科联盟（FIGO）分期呈正相关（rs=0.538,P=0.000）;HE4与CA125联合检测子宫内膜癌的敏感度比单独HE4检测的敏感度高。结论：单独血清HE4以及与CA125联合检测对子宫内膜癌早期诊断、分期及预后评估都有一定意义,可以作为诊断子宫内膜癌的重要指标。     

子宫腺肌病与子宫肌瘤的临床比较

目的 探讨子宫腺肌病与子宫肌瘤的临床特点及B超、实验室检测的价值，提高对子宫腺肌病术前的诊断率。方法 选择5年来我院妇产科子宫切除术后经病理证实的子宫腺肌病患者120例为子宫腺肌病组，随机选择同期子宫切除术后经病理证实的子宫肌瘤患者120例为子宫肌瘤组，对两组患者年龄分布、既往史、临床症状、术前诊断、B超检查、血清CA125水平进行比较。结果 两种疾病均好发于生育年龄妇女，常有月经过多或经期延长，经分析差异无显著性（P〉0．05）。子宫腺肌病术前诊断率56．1％，出现痛经、性交痛较多，但继发性贫血少；具有特征性的超声表现；血清CA125水平明显升高。结论 子宫腺肌病诊断的金标准是病理诊断，但其既往史、特有症状、B超改变、血清CA125水平增高仍是诊断该病的重要参考指标，并可与子宫肌瘤进行手术前鉴别。     

血清CA125和CA199与子宫内膜异位症患者术后妊娠率关系研究

目的探讨术前血清CA125和CA199水平与子宫内膜异位症合并不孕患者术后妊娠率的关系。方法随访汕头市中心医院2012年1月至2015年6月138例手术治疗的子宫内膜异位症患者,分析术前血清CA125、CA199水平与内异症的严重程度、术后自然妊娠率的关系,以及内异症的严重程度与患者术后自然妊娠率的关系。结果术前血清CA125、CA199水平与子宫内膜异位症的严重程度显著相关(P=0.001,P=0.018);术后自然妊娠组的CA125、CA199水平低于未妊娠组(CA125的中位数两组分别为49.00 k U/L,53.38 k U/L;CA199的中位数两组分别为15.11 k U/L,23.48 k U/L),但其差异无统计学意义(P值分别为0.770、0.407)。对于不同程度的内异症(Ⅰ~Ⅱ期,Ⅲ~Ⅳ期),术后的自然妊娠率差异无统计学意义(61.5%,65.0%)。结论术前CA125、CA199水平对预测术后自然妊娠率无重要价值,Ⅲ~Ⅳ期患者术后妊娠率与Ⅰ~Ⅱ期类似,故皆可考虑先期待自然妊娠。     

Duration of dysmenorrhoea and extent of adenomyosis visualised by magnetic resonance imaging

OBJECTIVE: Enlargement of the junctional zone (JZ) on T2-weighted resonance imaging of the uterus has recently been established as the major criterion for adenomyosis in patients with endometriosis. This study was conducted to analyse the extent of adenomyosis using magnetic resonance imaging (MRI) and relate it to the duration of dysmenorrhoea. STUDY DESIGN: This was a prospective study of 70 patients presenting with the complaint of severe dysmenorrhoea. Forty patients (57%) reported dysmenorrhoea as their major complaint and 30 patients (43%) suffered additionally from infertility. Group I (n=40) consisted of patients with dysmenorrhoea of between 1 and 10 years' duration, group II (n=30) consisted of patients with dysmenorrhoea of longer than 11 years' duration. All patients underwent laparoscopy to detect the presence and degree of endometriosis, and all patients underwent T2-weighted resonance imaging of the uterus to detect the extent of adenomyosis by measurement of the "junctional zone". RESULTS: In group I, adenomyosis could be detected via MRI in 21 patients (52.5%), while 19 patients (47.5%) showed no signs of adenomyosis. By contrast, in group II a distinct enlargement of the JZ, as the major radiological criterion of adenomyosis, could be observed in 26 patients (87%), while only 4 patients (13%) revealed no signs of adenomyosis (p=0.04). The mean thickness of the JZ was significantly enlarged in group II (11.07 mm) compared with group I (6.38 mm; p<0.0001). The prevalence of adenomyosis in endometriosis after dysmenorrhoea of more than 11 years' duration was 87%. CONCLUSIONS: In deep infiltrating endometriosis, a correlation between a specific localisation and dysmenorrhoea can often not be found. Recently, endometriosis and adenomyosis have been believed to result from a common uterine disease, the dislocation of the basal endometrium. Our data clearly show that dysmenorrhoea of long duration in patients who have had endometriosis for over a threshold value of 11 years is significantly related to adenomyosis of the uterus. Hence, evaluation of adenomyosis using MRI should become a standard procedure in cases of dysmenorrhoea and endometriosis. Severe dysmenorrhoea of long duration should always focus clinical interest on adenomyosis of the uterus.     

The influence of adenomyosis in patients laparoscopically treated for deep endometriosis

STUDY OBJECTIVE: A strong association exists between adenomyosis and endometriosis and a common pathogenetic mechanism was proposed. The aim of this study was to evaluate whether and how the presence of concurrent adenomyosis can affect the outcome of laparoscopic excision of deep endometriosis. DESIGN: Data were retrospectively collected from our computerized medical records (Canadian Task Force classification II-3). SETTING: General hospital. INTERVENTION: Restrospective evaluation. PATIENTS: From January 2003 through July 2005, 40 consecutive patients affected by concomitant endometriosis and adenomyosis were included in group A and another 40 affected by endometriosis only were included in group B. MEASUREMENTS AND MAIN RESULTS: In group A, 20 women required bowel surgery (17 segmental and 3 full-thickness discoid resections) versus 16 patients in the other group (13 segmental bowel resections with end-to-end anastomosis and 3 discoid resections). Dysmenorrhea and dyspareunia after treatment improved (p <.01) in both groups, whereas dyschezia improved only in group A. The persistence of menometrorrhagia was more frequent in group B (p <.01). During follow-up, patients of group A underwent medical treatment for a longer time than those of group B (p <.001). Clinical detection of endometriosis recurrence was more frequent in patients with adenomyosis (p <.01), whereas no difference existed in the incidence of the recurrence detected by ultrasound. The overall number of pregnancies after surgery was significantly lower in the group with adenomyosis (p = .03). CONCLUSION: Complete excision of deep endometriosis is not always feasible because of adenomyosis. For this reason, preoperative imaging screening for adenomyosis could be included in the preoperative workup when extensive disease is clinically suspected.     

Effect of atosiban on in vitro fertilization pregnancy outcome among women with endometriosis in presence or absence of adenomyosis

ObjectiveThis study aimed to assess the effect of atosiban on in vitro fertilization (IVF) pregnancy outcome among women with both endometriosis and adenomyosis, and compared it to that of patients with endometriosis but without adenomyosis and that of patients with tubal factor only.Materials and methods106 infertile women (176 embryo transfers) from a medical center in Taiwan were included in the analysis, where 34 (54), 34 (66), and 38 (56) cases (embryo transfers) were endometriosis without adenomyosis, endometriosis with adenomyosis, and tubal infertility factor only, respectively. Adenomyosis morphologies were classified using an ultrasound-based classification system. The logistic generalized estimating equation model was used to analyze the association between atosiban use and pregnancy outcomes.ResultsThe crude pregnancy rates for the endometriosis-only group were significantly higher than those for the endometriosis + adenomyosis group (i.e., biochemical pregnancy: 50.0% versus 29.7%, p = 0.041; ongoing pregnancy: 35.2% versus 16.9%, p = 0.038). Significantly higher chances of biochemical pregnancy and ongoing pregnancy among endometriosis patients without adenomyosis versus those with both endometriosis and adenomyosis were found (odds ratios [95% confidence intervals]: 2.981 [1.307, 6.803]; p = 0.009, 2.694 [1.151, 6.304]; p = 0.022). A significant positive association between atosiban use and biochemical pregnancy existed among endometriosis cases without adenomyosis (a 2.43-fold [1.01, 5.89] increase in successful pregnancy; p<0.05), but not for the other groups.ConclusionsPoor pregnancy outcomes among adenomyosis-affected women were confirmed. The use of atosiban significantly enhanced IVF pregnancy among endometriosis patients without adenomyosis.     

阴道超声对诊断治疗卵巢子宫内膜异位囊肿及子宫腺肌病的价值

目的探讨阴道超声及血清CA125测定对诊断治疗卵巢子宫内膜异位囊肿及子宫腺肌病的价值。方法对卵巢子宫内膜异位囊肿及子宫腺肌病患者631例进行回顾性分析，术前均经阴道超声检查，部分患者进行了血清CA125测定。结果阴道超声检查卵巢子宫内膜异位囊肿符合率98．7％；子宫腺肌病符合率91．7％；卵巢子宫内膜异位囊肿合并子宫腺肌病符合率95．1％。血清CA125检查卵巢子宫内膜异位囊肿，阳性率39．4％；子宫腺肌病阳性率52．2％；卵巢子宫内膜异位囊肿合并子宫腺肌病阳性率59．2％。结论阴道超声可做为较准确诊断卵巢子宫内膜异位囊肿及子宫腺肌病的首选方法。阴道超声下囊肿穿刺是治疗卵巢子宫内膜异位囊肿的简便、有效的方法之一。血清CA125测定可做为卵巢子宫内膜异位囊肿及子宫腺肌病的协助诊断方法，应进一步完善对照组的研究。     

Uterotubal transport disorder in adenomyosis and endometriosis--a cause for infertility

OBJECTIVE: Uterine hyperperistalsis and dysperistalsis are common phenomena in endometriosis and may be responsible for reduced fertility in cases of minimal or mild extent of disease. Since a high prevalence of adenomyosis uteri has been well documented in association with endometriosis, we designed a study to examine whether hyperperistalsis and dysperistalsis are caused by the endometriosis itself or by the adenomyotic component of the disease. DESIGN: A prospective observational study. SETTING: University hospital, Department of Obstetrics and Gynaecology, Division of Reproductive Medicine and Gynaecologic Endocrinology with 300 in vitro fertilisation/intracytoplasmatic sperm injection cycles and 350 intrauterine insemination cycles/year. POPULATION: Forty-one subjects with infertility and with laparoscopically proven endometriosis and patent fallopian tubes. Thirty-five subjects (85%) additionally showed signs of adenomyosis. METHODS: All subjects underwent T2-weighed magnetic resonance imaging (MRI) and hysterosalpingoscintigraphy (HSSG) during the subsequent menstrual cycle. MRI revealed the extent of the adenomyotic component of the disease and the integrity of uterotubal transport capacity was evaluated by HSSG. MAIN OUTCOME MEASURES: Influence of adenomyosis on uterotubal transport capacity in endometriosis. RESULTS: In 35 of the 41 subjects (85%) with endometriosis, signs of adenomyosis were detected using T2-weighed MRI. Two of six (33%) subjects with no adenomyosis (group I) showed dysperistalsis and hyperperistalsis, compared with 14 of 24 (58%) women with focal adenomyosis (group II) and 10 of 11 (91%) women with diffuse adenomyosis (seven showed a failure in transport capacity and two contralateral transport). CONCLUSIONS: Our data suggest that endometriosis is associated with impeded hyperperistaltic and dysperistaltic uterotubal transport capacity. However, adenomyosis is of even more importance, especially when diffuse adenomyosis is detected. Both forms of adenomyosis are commonly found in subjects with mild to moderate endometriosis. We suggest that the extent of the adenomyotic component in subjects with endometriosis explains much of the reduced fertility in subjects with intact tubo-ovarian anatomy.     

散结镇痛胶囊对子宫内膜异位症及子宫腺肌病痛经治疗效果观察

目的评价散结镇痛胶囊对子宫内膜异位症及子宫腺肌病痛经的临床治疗价值。方法以2008年12月至2009年3月北京协和医院收治的61例主诉中重度痛经症状的子宫内膜异位症和子宫腺肌病患者为研究对象,45例进入研究组(给予散结镇痛胶囊治疗),16例进入对照组(给予非甾体抗炎药治疗),进行前瞻性对照研究。结果研究组用药后痛经症状完全缓解8例,部分缓解30例,无效7例,有效率84.4%;对照组痛经完全缓解0例,部分缓解6例,有效率37.5%,两组相比差异有统计学意义(P<0.05)。两组子宫体积大小无明显变化。结论散结镇痛胶囊能有效缓解子宫内膜异位症和子宫腺肌病患者的痛经症状,副反应小。     

Clinical usefulness of determination of CA 125 levels in the serum and menstrual blood

We measured CA 125 levels in sera and menstrual blood of subjects with a normal ovulatory cycle and in those with endometriosis. Serum CA 125 levels were higher in the latter, in each phase of the menstrual cycle. The CA 125 levels in patients with endometriosis, particularly those with adenomyosis, tend to be higher than in those with a normal ovulatory cycle. We propose that measurement of CA 125 in the menstrual blood may be able to help distinguishing adenomyosis from myoma uteri and may also help in assessing clinical endometriosis.     

TNFR1在子宫内膜异位症和子宫腺肌病表达的研究

目的:探讨肿瘤坏死因子受体1(TNFR1)在子宫内膜异位症(内异症)和子宫腺肌病(腺肌病)的表达及在其发病机制中的作用。方法:采用免疫组化SABC法检测33例内异位症患者(内异症组)和40例腺肌病患者(腺肌病组)在位及异位子宫内膜TNFR1的表达,并与20例非内异症(对照组)在位内膜进行比较。结果:内异症组和腺肌病组异位内膜TNFR1的表达水平显著低于其在位内膜和对照组(P<0.05);TNFR1在内异症Ⅰ-Ⅱ期和Ⅲ-Ⅳ期间无显著差异(P>0.05),与内异症r-AFS临床分期亦无直线相关关系(P>0.05);TNFR1在分泌期的表达为内异症、腺肌病异位内膜<其在位内膜<对照组内膜(P<0.05)。结论:异位内膜TNFR1的低表达可能在内异症和腺肌病的发生中起重要作用。TNFR1与内异症严重程度无关。