Expression And Clinical Significance Of MiR-17-5p、MiR-199a And MMP-9 In The Serum Of Patients With Endometriosis

Objective:Endometriosis(EMS) is a benign disease,but it has malignant biological behavior such as tissue invasion, distant planting and growing.Endometriosis occurs mainly in child-bearing period.EMS is a major cause of dysmenorrhea, infertility and pelvic adhesions.Its mechanism of pathogenesis is unclear so far.Currently,the gold standard for the clinical diagnosis of EMS is surgical evaluating by laparoscopy.As result,the diagnosis and treatment of endometriosis are usually difficult and delayed due to the lack of biomarkers in the early stage.Endometriosis seriously impact on women’s health and quality of life. miRNA, which functions in RNA silencing and regulation of gene expression.In recent years, a large number of studies have shown that,differences in miRNA expression is closely related with endometriosis.MMP-9 belongs to the family of matrix metalloproteinases.The main feature is the degradation and remodeling of the extracellular matrix. Present study shows,MMP-9 plays an important role in ectopic endometrial cells adhesion, planting and growing. The expression and clinical significance of miRNAs and MMP-9 in serum of patients with endometriosis can be detected by this study that is to offer some evidence for diagnosis and molecule mechanism of endometriosis.Methods:We collected the serum samples from 40 endometriosis patients, who accepted laparoscopic treatment and pathologically confirmed(12 patients with peritoneal endometriotic lesions).Recording the patient’s age, body mass index, degree of pain (including chronic pelvic pain, dysmenorrhea), peritoneal and ovarian ectopic lesion size and the adhesion range in surgery.Using the serum samples from 20 patients examined of infertility and diagnosed with hydrosalpinx (excluding endometriosis and adenomyosis) as the control group.Using SYBR Green I real-time PCR and ELISA,two grops are detected to the expression levels of miR-17-5p> miR-199a and MMP-9. The relationship between clinical features(r-AFS stage, pain and peritoneal endometriotic lesions) and both this two miRNAs and MMP-9 is analyzed In the EMS group.In addition,we also analyze the correlation between MMP-9 and both miR-17-5p and miR-199a.Construction of ROC curve to estimate miR-17-5p and miR-199a applied to the diagnostic value of the EMS.Using SPSS17.0 software for statistical analysis of experimental data.Results:Serum levels of miR-17-5p in endometriosis significantly decreased versus the control group (Z=-2.464,P=:0.014),had nothing to do with r-AFS staging、pain and peritoneal endometriotic lesions (P=0.072,0.173,0.710).The relative expression levels of miR-199a was found to be down-regulated in endometriosis patients serum samples compared with control sampls (Z=-2.090,P=0.037).Changes in serum of miR-199a was negatively correlated with r-AFS staging (p=0.038), regardless of pain and peritoneal endometriotic lesions (P=0.151、0.592) The expression levels of MMP-9 in EMS group was higher than the control group.(t=2.548,p=0.003), and it was increased with r-AFS staging (P=0.028), had nothing to do with pain and peritoneal endometriotic lesions (p=0.174、0.186).Between miR-199a and MMP-9 expression levels exist negatively correlated (r=-0.501,p=0.024),and the relationship between miR-17-5p and MMP-9 exist no connection (r=-0.419,p=0.066). miR-17-5p and miR-199a showed ROC curve area of 0.780,0.738, and a sensitivity of 80%,70%, and a specificity of 65%.85%,and 95% confidence interval [0.609-0.951], [0.506-0.969]respectively.Conclusion:1.Serum levels of miR-17-5p and miR-199a in endometriosis significantly decreased.Changes in serum of miR-199a was negatively correlated with r-AFS staging.2.The expression levels of MMP-9 in endometriosis significantly decreased, and it was increased with r-AFS staging.3.Between miR-199a and MMP-9 expression levels exist negatively correlated.4. Serum of miR-17-5p and miR-199a for diagnosing EMS had higher accuracy, and maybe have some value.