子宫内膜异位症患者血清中 PAPP-A，IGF-I水平及 PAPP-A基因 rs7020782 A/C位点多态性与临床分期相关性研究

目的　研究子宫内膜异位症（ endometriosis，EMs）患者血清中妊娠相关血浆蛋白 -A（pregnancy-associated plasma protein-A，PAPP-A）、胰岛素样生长因子 -I（insulin-like growth factor-I，IGF-I）水平及 PAPP-A基因 rs7020782 A/C位点单核苷酸多态性（ SNP）与临床分期的相关性。方法　选择 EMs确诊者 176例作为 EMs组，同期非 EMs育龄妇女 120例作为对照组。分别检测血清中 PAPP-A和 IGF-I水平，同时分析 PAPP-A基因 rs7020782 A/C位点 SNP。结果　EMs组 PAPP-A和 IGF-I水平（ 16.38±5.29mIU/L和 145.47±18.02ng/ml）明显高于对照组（ 7.42±2.83mIU/L和

Study on the Correlation between the Levels of PAPP-A,IGF-I and PAPP-A Gene rs7020782 A/C Loci Polymorphism andClinical Stage in Patients with Endometriosis

Objective　To Study on the correlation between the levels of pregnancy-associated plasma protein-A(PAPPA),insulin-like growth factor-I(IGF-I) and PAPP-A gene rs7020782 A/C loci polymorphism and clinical stage in patients withendometriosis(EMs). Methods　176 patients diagnosed with EMS were selected as the EMS group, and 120 non-EMS womenof childbearing age were selected as the control group. The levels of PAPP-A and IGF-I were detected, and the SNP of PAPP-Agene rs7020782 A/C was analyzed. Results　The levels of PAPP-A and IGF-I in EMS group(16.38±5.29mIU/L and145.47±18.02ng/ml) were significantly higher than those in control group(7.42±2.83mIU/L and 81.34±12.61ng/ml),and thedifference was statistically significant(t=7.018 5, 5.624 1, all P<0.05).The levels of PAPP-A and IGF-I increased with the increaseof clinical stage,and the differences among different stages were statistically significant(F=14.608 3, 12.371 5, all P<0.05).Therewas positive correlation between PAPP-A and IGF-I level(r=0.790 2, P=0.026 1),and there were positive correlation between thelevels of PAPP-A and IGF-I and clinical stage(r=0.612 7, 0.735 8, all P<0.05). CC genotype and C allele frequency of PAPP-Ars702078 2A /C locus in EMS group(68.75% and 78.41%) were significantly higher than those in control group (46.67%and 55.83%), the difference were statistically significant(χ2=6.052 3, 4.392 1, all P<0.05). CC genotype and C allele wereassociated with an increased relative risk of EMS(OR=3.095, 95%CI: 1.982 ～ 6.873 and OR=2.607, 95%CI:1.821~4.759). Thelevel of PAPP-A in EMS patients with CC genotype(18.48±7.13 mIU /L) was significantly higher than that of AC and AAgenotypes(12.03±3.86 mIU/L and 11.42±3.51 mIU/L), and the difference were statistically significant(t=6.841 2, 7.061 4, allP<0.05),but there was no statistically significant difference between AC and AA genotypes(t=0.852 4, P>0.05). Conclusion　Theserum levels of PAPP-A and IGF-I in EMS patients were significantly increased, which was related to the clinical stage, and maybe closely related to the occurrence of EMS. At the same time, rs7020782 A/C locus of PAPP-A gene was polymorphic, and CCgenotype may be associated with the prevalence of EMS in this region.