摘要
目的探讨高强度聚集超声(HIFU)治疗对子宫肌瘤患者血清环氧化酶-2(COX-2)表达及血管新生的影响。方法前瞻性选择2017年2月至2019年10月于西安交大附属西北妇女儿童医院行HIFU治疗的子宫肌瘤患者44例作为HIFU组。收集其子宫肌瘤组织及对应瘤旁正常组织,采用免疫组织化学染色法确定COX-2在子宫肌瘤组织中表达率。同时随机选择同期内采用药物治疗的子宫肌瘤患者44例作为药物组。经病理档案室酶联免疫吸附(ELISA)法检测两组治疗前后血清COX-2水平和血管新生因子血管内皮生长因子(VEGF),并分析COX-2与VEGF的关系;六氟化硫微泡超声造影实时判断海扶术中肌瘤消融情况,术后1、3、6、12个月B超监测肌瘤缩小情况。结果瘤体组织中COX-2阳性表达率68.18%,高于瘤旁正常组织中COX-2阳性表达率27.27%,差异有统计学意义(P<0.05)。治疗后,HIFU组血清COX-2、VEGF低于药物组[(10.12±3.01)ng/mL vs.(22.35±4.36)ng/mL、(86.33±10.47)pg/mL vs.(163.54±22.06)pg/mL],差异有统计学意义(P<0.05);HIFU组COX-2和VEGF呈正相关关系(r=0.235,P=0.000)。治疗后1个月两组肌瘤消融率比较[(19.42±6.55)%vs.(22.67±6.68)%],差异无统计学意义(P>0.05);HIFU组术后3、6、12个月肌瘤消融率大于药物组[(26.98±6.83)%vs.(18.66±6.42)%、(39.96±15.54)%vs.(20.22±10.09)%、(81.02±22.35)%vs.(47.88±16.63)%],差异有统计学意义(P<0.05)。结论HIFU治疗可直接消融促进肌瘤组织坏死,可能通过下调COX-2表达而抑制血管新生,促进肌瘤缩小、减少肌瘤复发。
Objective To investigate the effect of high-intensity focused ultrasound(HIFU)on serum cyclooxygenase-2(COX-2)expression and angiogenesis in patients with uterine fibroids.Methods 44 patients with uterine fibroids underwent HIFU(HIFU group)and 44 patients with drug treatment(drug treatment group)in our hospital from February 2017 to October 2019 were enrolled;collecting the uterine myoma tissues and adjacent normal tissues,The expression rate of COX-2 in uterine myoma tissues was detected by immunohistochemistry.The level of serum COX-2 and vascular endothelial growth factor(VEGF)were detected by ELISA,and analyse the relationship between COX-2 and VEGF.The clinical efficacy of ablation was evaluated by sulfur hexafluoride microbubble contrast-enhanced ultrasound.The myoma size was observed at postoperative 1mon,3mon,6mon and 12mon.Results The positive expression level of COX-2 in tumor tissues was 68.18%higher than that in adjacent tumor tissues 27.27%(P<0.05).After treatment,the serum level of COX-2 and VEGF in HIFU group were lower than those of drug treatment group[(10.12±3.01)ng/mL vs.(22.35±4.36)ng/mL,(86.33±10.47)pg/mL vs.(163.54±22.06)pg/mL,P<0.05].The relative expression level of COX-2 in HIFU group was positively correlated with VEGF(r=0.235,P=0.000).A month after treatment,the comparison of the ablation rate of fibroids between the two groups[(19.42±6.55)%vs.(22.67±6.68)%],the difference was not statistically significant(P>0.05).The ablation volume of myoma of HIFU group was higher than that of drug treatment group at postoperative 3mon,6mon and 12mon[(26.98±6.83)%vs.(18.66±6.42)%,(39.96±15.54)%vs.(20.22±10.09)%,(81.02±22.35)%vs.(47.88±16.63)%,P<0.05].Conclusion HIFU can promote myoma necrosis by direct ablation,inhibit angiogenesis maybe by down regulating COX-2 expression,thus promote myoma reduction and reduce myoma recurrence.
作者
樊晓慧
单莉
何菊仙
邓晓红
刘娟弟
张梦霓
FAN Xiao-hui;SHAN Li;HE Ju-xian(Department of Gynecology,Xi'an Jiaotong University Affiliated Northwest Women and Children's Hospital,Xi'an Shaanxi 710000,China)
出处
《临床和实验医学杂志》
2020年第19期2099-2103,共5页
Journal of Clinical and Experimental Medicine
基金
陕西省卫生健康科研基金项目(No.2018D036)。
关键词
高强度聚集超声
子宫肌瘤
环氧化酶-2
血管新生
High-intensity focused ultrasound
Uterine fibroids
Cyclooxygenase-2
Angiogenesis
