该研究的目的是评估血清自身抗体的概况及其在卵巢子宫内膜瘤(OEM)和深部浸润型子宫内膜异位症(DIE)中的诊断和致病意义。该研究纳入了74例子宫内膜异位症患者(第1组),包括53例OEM患者(1a亚组);21例无卵巢病变的DIE患者(1b亚组);27例无子宫内膜异位症患者(第2组)。通过腹腔镜手术和切除组织的组织学检查证实了诊断。抗体(M,G)至原肌球蛋白3(TPM),原调节素3(TMOD),α-烯醇化酶(ENO),雌二醇(E2),孕酮(PG),使用改良的ELISA在血清中鉴定了人绒毛膜促性腺激素(hCG)。在子宫内膜异位症中,子宫内膜抗原的抗体,荷尔蒙,与抗磷脂和抗核抗体相比,ENO的检测频率更高。更高水平的IgM到TPM,hCG,E2,PG和IgG到TMOD,ENO,与第2组相比,在1a亚组中发现了E2和hCG。IgM到TPM,hCG,E2,PG,IgG对E2和ENO对OEM有较高的诊断价值(AUC>0.7),TPM抗体具有最高的敏感性和特异性(73.6%和81.5%)。在第1b子组,只有TPM和hCG的IgM水平高于第2组。这些抗体对DIE具有较高的诊断价值。因此,子宫内膜异位症与子宫内膜抗原的自身抗体有关,α-烯醇化酶,类固醇,和促性腺激素。在OEM中比在DIE中检测到更广谱的抗体。这些抗体对OEM和DIE具有很高的诊断价值,对子宫内膜异位症和相关不孕症具有潜在的致病意义。
The objective of the study was to evaluate the profile of serum autoantibodies and their diagnostic and pathogenetic significance in ovarian endometrioma (OEM) and deep infiltrative endometriosis (DIE). The study enrolled 74 patients with endometriosis (Group 1), including 53 patients with OEM (Subgroup 1a); 21 patients with DIE without ovarian lesions (Subgroup 1b); and 27 patients without endometriosis (Group 2). The diagnosis was confirmed by laparoscopic surgery and histologic examination of resected tissues. Antibodies (M, G) to tropomyosin 3 (TPM),
tropomodulin 3 (TMOD), α-enolase (ENO), estradiol (E2), progesterone (PG), and human chorionic gonadotropin (hCG) were identified in blood serum using modified ELISA. In endometriosis, antibodies to endometrial antigens, hormones, and ENO were detected more often than antiphospholipid and antinuclear antibodies. Higher levels of IgM to TPM, hCG, E2, and PG and IgG to TMOD, ENO, E2, and hCG were found in Subgroup 1a compared to Group 2. IgM to TPM, hCG, E2, PG, and IgG to E2 and ENO had a high diagnostic value for OEM (AUC > 0.7), with antibodies to TPM having the highest sensitivity and specificity (73.6% and 81.5%). In Subgroup 1b, only the levels of IgM to TPM and hCG were higher than in Group 2. These antibodies had a high diagnostic value for DIE. Thus, endometriosis is associated with autoantibodies to endometrial antigens, α-enolase, steroid, and gonadotropic hormones. A wider spectrum of antibodies is detected in OEM than in DIE. These antibodies have a high diagnostic value for OEM and DIE and potential pathogenetic significance for endometriosis and associated infertility.