[1]丁 辉,苏雪梅,张 蓉.子宫内膜异位症患者血清GP73和SMAD2表达水平及临床价值研究[J].现代检验医学杂志,2025,40(01):122-126,131.[doi:10.3969/j.issn.1671-7414.2025.01.023]
　DING Hui,SU Xuemei,ZHANG Rong.Study on the Expression Level of Serum GP73 and SMAD2 and Clinical Value in Patients with Endometriosis[J].Journal of Modern Laboratory Medicine,2025,40(01):122-126,131.[doi:10.3969/j.issn.1671-7414.2025.01.023]
点击复制

子宫内膜异位症患者血清GP73和SMAD2表达水平及临床价值研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年01期
页码:
122-126,131
栏目:
论著
出版日期:
2025-01-15

文章信息/Info

Title:
Study on the Expression Level of Serum GP73 and SMAD2 and Clinical Value in Patients with Endometriosis
文章编号:
1671-7414（2025）01-122-06
作者:
丁 辉，苏雪梅，张 蓉
（新疆军区总医院妇产科，乌鲁木齐 830000）
Author(s):
DING Hui，SU Xuemei，ZHANG Rong
（Department of Obstetrics and Gynecology，Xinjiang Military Region General Hospital，Urumqi 830000，China）
关键词:
高尔基体蛋白73; SMAD 家族成员2; 子宫内膜异位症
分类号:
R711.71；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.01.023
文献标志码:
A
摘要:
目的 探究血清中高尔基体蛋白73（GP73），SMAD 家族成员2（SMAD2）在子宫内膜异位症（endometriosis，EMT）中的表达及临床意义。方法 选取2022 年3 月～ 2023 年9 月新疆军区总医院收治的175 例EMT 患者作为观察组，根据EMT 分期将患者分为轻度组（Ⅰ期，n=61）、中度组（Ⅱ期，n=52）和重度组（Ⅲ ~ Ⅳ期，n=62）；选择同期进行体检的163 例健康女性作为对照组。采用ELISA 法对血清GP73，SMAD2 水平进行检测，并对观察组和对照组的一般资料进行比较。采用Logistic 回归模型分析患者发生EMT 的影响因素。采用Pearson 法对EMT 患者血清GP73与SMAD2 的水平相关性进行分析；ROC 曲线评估血清GP73，SMAD2 水平以及二者联合对EMT 患者的诊断价值。结果 两组患者是否存在痛经和月经不调比较，差异具有统计学意义（χ2=17.633，39.268，均P ＜ 0.001）。观察组血清GP73（73.68±19.23 ng/ml），SMAD2（42.27±9.61 mg/L）表达水平均高于对照组（58.61±13.27 ng/ml，35.26±6.37mg/L），差异具有统计学意义（t=8.327，7.845，均P ＜ 0.05）。轻度组、中度组、重度组血清GP73（59.79±17.26 ，73.73±18.17l，87.29±22.05 ng/ml）和SMAD2（35.18±7.39，39.97±9.45，51.17±11.96 mg/L）水平依次增加，差异具有统计学意义（F=31.067，42.866，均P ＜ 0.05）。Pearson 法分析EMT 患者血清GP73 水平与SMAD2 水平呈正相关（r=0.427，P<0.001）。多因素Logistic 回归分析显示，月经不调、痛经、血清GP73[OR（95%CI）：2.035（1.208 ～ 3.428）]，SMAD2[OR（95%CI）：1.972（1.284 ～ 3.029）] 水平是患者发生EMT 的危险因素（均P ＜ 0.05）。血清GP73 和SMAD2 联合诊断EMT 的AUC（95%CI） 为0.821（0.776 ～ 0.861）， 高于血清GP73 和SMAD2 单独诊断[0.763（0.714 ～ 0.807），0.708（0.656 ～ 0.756）]，差异具有统计学意义（Z=3.121，4.346，均P ＜ 0.05）。结论 EMT 患者血清GP73，SMAD2 水平升高，均与患者的病情程度有关，对EMT 有一定诊断价值。
Abstract:
Objective To investigate the expression and clinical significance of serum Golgi protein 73 (GP73) and SMAD family member 2 （SMAD2）in endometriosis. Methods From March 2022 to September 2023, 175 patients with endometriosis who visited Xinjiang Military Region General Hospital were collected as the observation group. According to the staging of endometriosis, patients were separated into mild group (stage I，n=61), moderate group (stage II，n=52 ) and severe group (stage III-IV，n=62). The healthy group comprised 55 healthy individuals who underwent medical examinations from December 2020 to December 2022 at Xinjiang Military Region General Hospital. ELISA was applied to detect serum GP73 and SMAD2 levels, the general data of the observation group and the control group were compared. Logistic regression was used to analyze the relevant factors affecting the occurrence of endometriosis，the Pearson method was applied to investigate the correlation between serum GP73 and SMAD2 levels in patients with endometriosis．ROC curves were used to assess the diagnostic value of serum GP73，SMAD2 levels and their combination in patients with EMT. Results The presence or absence of dysmenorrhea and irregular menstruation was compared between the two groups, and the differences were statistically significant (χ2=17.633， 39.268，all P<0.001). Serum GP73 (73.68±19.23 ng/ml)，SMAD2 (42.27±9.61 mg/L) expression levels in the observation group were higher than those in the control group (58.61±13.27 ng/ml, 35.26±6.37 mg/L), and the differences were statistically significant (t=8.327, 7.845, all P<0.05). GP73 (59.79±17.26, 73.73±18.17, 87.29±22.05ng/ml) and SMAD2 (35.18±7.39, 39.97±9.45, 51.17±11.96mg/L) increased sequentially in the mild, moderate and severe groups, and the differences were statistical significance (F=31.067, 42.866, all P<0.05). Pearson analysis showed serum GP73 levels were positively correlated with SMAD2 levels in EMT patients (r=0.427, P<0.001)．Multifactorial Logistic regression analysis showed that irregular menstruation, dysmenorrhea, serum GP73 [OR(95%CI) ：2.035 (1.208 ～ 3.428)], SMAD2 [OR(95%CI)： 1.972 (1.284 ～ 3.029)] levels were risk factors for the development of EMT in patients (all P<0.05). The AUC(95%CI) for the combined diagnosis of EMT by serum GP73 and SMAD2 was 0.821 (0.776 ～ 0.861), which was higher than that of serum GP73 and SMAD2 alone [0.763 (0.714 ～ 0.807), 0.708 (0.656 ～ 0.756)], respectively, and the differences were statistically significant (Z=3.121, 4.346, all P<0.05). Conclusion Elevated serum GP73 and SMAD2 levels in EMT patients are all related to the extent of the patient’s condition and have some diagnostic value for EMT.

参考文献/References:

[1] FARKAS A H, ABUMUSA H, ROSSITER B. Structural gynecological disease: fibroids, endometriosis, ovarian cysts[J]. the Medical Clinics of North America, 2023, 107(2): 317-328.
[2] VANNUCCINI S, CLEMENZA S, ROSSI M, et al. Hormonal treatments for endometriosis: the endocrine background[J]. Reviews in Endocrine Metabolic Disorders, 2022, 23(3): 333-355.
[3] 张琦，周锋，李岚，等. 子宫内膜异位症患者腹腔镜手术后首次IVF-ET 的治疗结局分析[J]. 中华妇产科杂志，2023,58(2):91-97． ZHANG Qi, ZHOU Feng, LI Lan, et al. Analysis of reproductive outcomes in the first IVF-ET cycle after laparoscopic treatment in patients with endometriosis [J]. Chinese Journal of Obstetrics and Gynecology, 2023, 58(2): 91-97.
[4] DINSDALE N L, CRESPI B J. Endometriosis and polycystic ovary syndrome are diametric disorders[J]. Evolutionary Applications, 2021, 14(7): 1693-1715.
[5] 张园, 蒋春艳, 吴畏, 等. 中重度子宫内膜异位症患者血清中抗核抗体、抗心磷脂抗体和抗β2 糖蛋白1 抗体的检测价值[J]．国际生殖健康/ 计划生育杂志，2020,39(2):97-100. ZHANG Yuan, JIANG Chunyan, WU Wei, et al. Detection of antinuclear antibody, anticardiolipin antibody and anti-β2 glycoprotein 1 antibody in patients with moderate or severe endometriosis [J]. Journal of International Reproductive Health/Family Planning, 2020, 39(2): 97-100.
[6] CHRISTOPH G , ULRIKE S ,WENTZECK REN?，et al. How can we measure endometriosis-associated pelvic pain?[J].Journal of Endometriosis, 2018, 4(3):109-116.
[7] 马杨青, 范海纳, 孙鑫, 等. 高尔基体蛋白73(GP73)对慢性肝病的诊断价值[J]. 临床肝胆病杂志,2023,39(8):1999-2004． MA Yangqing, FAN Haina, SUN Xin, et al. Role of Golgi protein 73(GP73) in diagnosis of chronic liver diseases [J]. Journal of Clinical Hepatology, 2023, 39(8): 1999-2004.
[8] 何平, 徐婧怡, 张雪雪, 等. AFP，GP73 及GPC3 检测在原发性肝癌诊断及预后评估中的价值[J]. 分子诊断与治疗杂志，2024,16(1):36-40. HE Ping, XU Jingyi, ZHANG Xuexue, et al. Value of serum AFP,GP73 and GPC3 detection in the diagnosis and prognosis assessment of primary liver cancer [J]. Journal of Molecular Diagnostics and Therapy, 2024, 16(1): 36-40.
[9] LI Hengcun, ZHANG Zheng, CHEN Lei, et al. Cytoplasmic asporin promotes cell migration by regulating TGF-β/Smad2/3 pathway and indicates a poor prognosis in colorectal cancer[J]. Cell Death & Disease, 2019, 10(2): 109.
[10] 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. Chinese Obstetricians and Gynecologists Association， Cooperative Group of Endometriosis, Chinese Society of Obstetrics and Gynecology Chinese Medical Association．Guideline for the diagnosis and treatment of endometriosis (Third edition) [J]. Chinese Journal of Obstetrics and Gynecology, 2021, 56(12): 812-824.
[11] 王慧婷，郭兆荣，刘晓燕．外周血Fib，NLR 和IL-6对中重度卵巢型子宫内膜异位症的诊断价值[J]．江苏医药，2023,49(3):272-275． WANG Huiting, GUO Zhaorong, LIU Xiaoyan. Value of Fib, NLR and IL-6 in peripheral blood in diagnosing patients with moderate to severe ovarian endometriosis [J]. Jiangsu Medical Journal, 2023, 49(3): 272-275.
[12] 陈丽， 赵威， 李珊珊， 等． 临床特征联合血清CA19-9,HE4 对子宫内膜异位症相关卵巢癌症的诊断价值[J]. 海南医学,2024,35(1):76-79． CHEN Li, ZHAO Wei, LI Shanshan, et al. Diagnostic value of clinical features combined with serum CA19-9 and HE4 in endometriosis-associated ovarian cancer [J]. Hainan Medical Journal, 2024, 35(1): 76-79.
[13] MOHAGHEGH F, HATAMI P, RAJABI P, et al. Coexistence of cutaneous endometriosis and ovarian endometrioma: a case report[J]. Journal of Medical Case Reports, 2022, 16(1): 256.
[14] PHUNG M T, MUTHUKUMAR A, TRABERT B, et al. Effects of risk factors for ovarian cancer in women with and without endometriosis[J]. Fertility and Sterility, 2022, 118(5): 960-969.
[15] CHAPRON C, MARCELLIN L, BORGHESE B, et al. Rethinking mechanisms, diagnosis and management of endometriosis[J]. Nature Reviews Endocrinology, 2019, 15(11): 666-682.
[16] ATIYA H I, FRISBIE L, GOLDFELD E, et al. Endometriosis-associated mesenchymal stem cells support ovarian clear cell carcinoma through Iron regulation[J]. Cancer Research, 2022, 82(24): 4680-4693.
[17] 张革伦，周琦，徐伏兰．探究不同治疗方式对卵巢子宫内膜异位症患者卵巢功能的影响[J]. 生殖医学杂志，2023,32(1):149-153. ZHANG Gelun, ZHOU Qi, XU Fulan. Effect of different treatment methods on ovarian function of patients with endometriosis [J]. Journal of Reproductive Medicine, 2023, 32(1): 149-153.
[18] 李楠，陈璐，冯晓玲．核转录因子(NF-κB) 信号通路与子宫内膜异位症发病关系的研究及针对性治疗[J]. 中国免疫学杂志，2019,35(4):509-514． LI Nan, CHEN Lu, FENG Xiaoling. Relationship between nuclear factor-kappa B( NF-κB) signaling pathway and pathogenesis of endometriosis and targeted therapy [J]. Chinese Journal of Immunology, 2019, 35(4): 509-514.
[19] KLADNEY R D, BULLA G A, GUO Lisheng, et al. GP73, a novel Golgi-localized protein upregulated by viral infection[J]. Gene, 2000, 249(1/2): 53-65.
[20] LIN Yifen, LI Miaohong, HUANG Rihua, et al. GP73 Enhances the Ox-Ldl-induced inflammatory response in THP-1 derived macrophages via affecting NLRP3 inflammasome signaling[J]. International Journal of Cardiology, 2023, 387: 131109.
[21] YANG Hanjie, LIU Geliang, LIU Bo, et al. GP73 promotes invasion and metastasis of bladder cancer by regulating the epithelial-mesenchymal transition through the TGF-β1/Smad2 signalling pathway[J]. Journal of Cellular and Molecular Medicine, 2018, 22(3): 1650-1665.
[22] 姚明解, 王雷婕, 关贵文, 等. 血清高尔基体蛋白73在辅助诊断慢性乙型肝炎患者中度以上肝损伤中的应用[J]. 临床肝胆病杂志,2018,34(4):755-759． YAO Mingjie, WANG Leijie, GUAN Guiwen, et al. Value of serum Golgi protein 73 in assisting the diagnosis of moderate or severe liver injury in patients with chronic hepatitis B [J]. Journal of Clinical Hepatology, 2018, 34(4): 755-759.
[23] 刘沁雨, 常越, 张文, 等.GP73 预测慢性乙型肝炎患者肝硬化进展研究[J]. 武警医学,2020,31(4):317-323. LIU Qinyu, CHANG Yue, ZHANG Wen, et al. Prediction of cirrhosis progression by GP73 in patients with chronic hepatitis B [J]. Medical Journal of the Chinese People’s Armed Police Force, 2020, 31(4): 317-323.
[24] 丰江岳， 钟辉． 高尔基体跨膜糖蛋白73 高表达诱发脂肪肝的脂类特性分析[J]. 生物工程学报,2022,38(6):2322-2331. FENG Jiangyue, ZHONG Hui. Lipid characteristics of fatty liver induced by high expression of Golgi protein 73 [J]. Chinese Journal of Biotechnology, 2022, 38(6): 2322-2331.
[25] 李冰冰，谢苗，郭亚楠，等．TGF-β1,Smads 在子宫内膜异位症中的表达和意义[J]．中国生育健康杂志，2022，33（1）：33-37． LI Bingbing, XIE Miao, GUO Ya’nan, et al. Expression and significance of TGF-β1 and Smads in endometriosis [J]. Chinese Journal of Reproductive Health, 2022, 33(1): 33-37.
[26] NIE Meifang, XIE Qi, WU Yahong, et al. Serum and ectopic endometrium from women with endometriosis modulate macrophage M1/M2 polarization via the SMAD2/SMAD3 pathway[J]. Journal of Immunology Research, 2018,2018(1):6285813.
[27] 宗欣, 吴周姜丽, 王达飞, 等.TGF-β1 和FBRS 可指示肝纤维化发展程度[J]．基因组学和应用生物学,2019,38(1):479-483． ZONG Xin，WU Zhoujiangli，WANG Dafei，et al. Development degree of hepatic fibrogenesis indicated by TGF-1 and FBRS [J]. Genomics and Applied Biology，2019, 38(1): 479-483.
[28] 罗亮，许剑利，程其军，等．卵巢子宫内膜异位囊肿患者血清APRIL 与NDRG1 的水平表达及其临床价值研究[J]. 现代检验医学杂志,2024,39(2):124-128. LUO Liang, XU Jianli, CHENG Qijun, et al. Expression of serum APRIL and NDRG1 levels in patients with ovarian endometrioma and their clinical value [J]. Journal of Modern Laboratory Medicine, 2024, 39(2): 124-128.

相似文献/References:

[1]李淑湘,郑维玲,石 燕,等.采用间接法建立苏州地区表观健康成人血清高尔基体蛋白73水平参考区间及验证[J].现代检验医学杂志,2026,41(01):161.[doi:10.3969/j.issn.1671-7414.2026.01.031]
　LI Shuxiang,ZHENG Weiling,SHI Yan,et al.Establishment and Validation of Reference Intervals of Golgi Protein 73 in Healthy Adults in Suzhou Area by Indirect Method[J].Journal of Modern Laboratory Medicine,2026,41(01):161.[doi:10.3969/j.issn.1671-7414.2026.01.031]

备注/Memo

备注/Memo:
作者简介：丁辉（1979-）女，硕士，副主任医师，研究方向：妇产科、产科，E -mail：ddfph50@163.com。
更新日期/Last Update: 2025-01-15