Expression And Clinical Significance Of TNF-a, VEGF, And MMP-3in Endometriosis

Objective1. To investigate the expression and correlation of tumor necrosis factor-α(TNF-a), vascular endothelial growth factor (VEGF), and matrix metalloproteinase-3(MMP-3) in serum, peritoneal fluid, eutopic endometrium, and ectopic endometrium ofendometriosis．2. To investigate its clinical signifrcance as a biomarker in the assessment andfollow-up of endometriosis.Methods30endometriosis patients who underwent hysterectomy were enrolled inour study, and30patients of hysteromyoma with normal endometrium tissue werecollected as the control group. Enzyme linked immunosorbent assay(ELISA) andimmunohistochemical staining were used to determine the expression of TNF-a, VEGF, andMMP-3in serum, peritoneal fluid, eutopic endometrium, and ectopic endometriumtissue．Results1. The expression level of TNF–a in serum and eritoneal fluid wassignificantly increased in the endometriosis patients compared with the control group(P<0.05). The levels of VEGF were increased in serm and peritoneal fluid in theendometriosis group relative to the control group ((P<0.05)．The levels of MMP-3were respectively increased in serum and peritoneal fluid in endometriosis grouprelative to in control group (P<0.05). There was no correlation among the Serumlevels of TNF-a and VEGF MMP-3in endometriceis group (P>0.05),but a positivecorrelation was observed in peritoneal fluid (P<0.05)．The levels of TNF-a, VEGF,and MMP-3in both serum and peritoneal fluid of moderate or Severe endornetriosis(stages Ⅲ-IV) patients were significantly higher than those in minute and lightendometriosis(stages I-Ⅱ)(P<0.05).2. Expression of VEGF, TNF-a and MMP-3in ectopic endometrium tissue wassignificantly higher than that in eutopic endometrium and normal endometrium (P<0.05)． Innormal endometrium，expression of VEGF and TNF-a in secretory phase were higher than that in proliferative phase (P<0.05)．but the expression of MMP-3in secretory phasewere significantly lower than that in proliferative phase (P<0.05). Tlhe expression ofVEGF and TNF-a was positively correlated with MMP-3(P<0.05).Conclusions1. TNF-a, VEGF, and MMP-3are increased in serum and peritoneal fluid ofendometriosis patients in consistence with disease severity, and the levels of TNF-a, VEGF,and MMP-3in peritoneal fluid are positively correlated but not in serum, supporting thehypothesis of endometriotic implants at ectopic sites．2. The increased expression of VEGF, TNF-a, and MMP-3in endometriosis patientsindicates that angiogenesis may play a role in the pathogenesis of endometriosis．...