Biomarkers Of Proliferative Phase Of Adenomyosis Based On Serum MiRNAs Expression And The Effect Of Chinese And Western Medicine On Its Candidate MiRNAs

Research Background:The diagnosis and classification of adenomyosis requires a comprehensive examination of the results of imaging and histopathological examination of adenomyosis.Although it is the current gold standard for pathological diagnosis,these methods are invasive,and the risk of lesions in pelvic organs is increased.Adenomyosis is often difficult to diagnose,and it usually delays the diagnosis time of 7-10 years.In contrast,blood-based liquid biopsy can provide a non-invasive and sensitive method.Serum miRNA has become a hotspot of molecular diagnosis in recent years and can be effectively applied in clinical practice.It has stable structure,convenient detection and low cost.With good repeatability and other advantages.The pur:pose of this project is to screen and obtain a combination of serum miRNAs biomarkers specific for adenomyosis,and to explore the feasibility of its application to clinical diagnosis.Based on serum miRNAs,it is used as a molecular marker to identify adenomyosis and The feasibility of gynecological benign tumor diagnosis,explore the effect of traditional Chinese medicine decoction Xuandan Sanjie Decoction and gonadotropin-releasing hormone agonist(GnRH-a)on candidate miRNAs in adenomyosis,and explore its effect as adenomyosis The possibility of observing the efficacy of the indicator.Research method:(1)Using high-throughput sequencing technology to screen all miRNAs in the serum of 30 patients with adenomyosis and normal female control group,and then use real-time quantitative PCR(qRT-PCR)in the proliferative serum.108 patients in the uterus and normal female control groups were screened and verified for differentially expressed candidate miRNAs.(2)Using qRT-PCR technology to select highly sensitive and differentially expressed candidate miRNAs in 96 female patients(including 24 cases of adenomyosis,uterine fibroids,endometrial polyps,and endometriosis)authenticating.(3)Thirty patients with adenomyosis were selected.Among them,12 were newly diagnosed patients without any treatment,and 12 were judged by TCM syndrome types.A patient with adenomyosis and stagnation of blood stasis type and received Xuandan Sanjie Decoction for 3 months.Twelve patients were diagnosed as adenomyosis by Western medicine and treated with GnRH-a for 3 cycles.The differentially expressed candidate miRNAs were verified by qRT-PCR in the above 30 samples of serum.Research result:(1)The expression level of miRNAs in the proliferative phase of the adenomyosis patients in the study group was significantly different from that in the control group,P<0.05.There were 249 up-regulated miRNAs and 64 down-regulated miRNAs.After flurther screening,we found that two miRNAs,has-mik-101-3p and has-miR-143-3p,were expressed in proliferative patients with adenomyosis.The amount is significantly increased.With the increase of menstrual flow and aggravation of dysmenorrhea,the expression of hsa-miR-101-3p in the serum of patients with adenomyosis showed an upward trend,hsa-miR-143-3p had no significant correlation with the menstrual score,but with the increase of dysmenorrhea,the expression of hsa-miR-143-3p in serum of patients with adenomyosis showed an increasing trend,and the expression levels of hsa-miR-101-3p and hsa-miR-143-3p were positively correlated with serum CA125 levels.(2)Hsa-miR-101-3p,hsa-miR-143-3p these two miRNAs are abnormally expressed in the serum of patients with adenomyosis compared with uterine fibroids,endometrial polyps,and endometriosis.(3)Hsa-miR-101-3p,hsa-miR-143-3p in the adenomyosis Xuandan Sanjie Decoction,GnRH-a treatment before and after treatment in patients with serum levels decreased significantly,P<0.05,with statistics learning meaning.Research conclusion:(1)Hsa-mik-101-3p,hsa-miR-143-3p is expected to be a molecular biological screening index for adenomyosis,and can be combined with menstrual flow,dysmenorrhea,CA125 and other results to conduct a preliminary study of adenomyosis.The stratified screening of stages provides the basis for non-invasive diagnosis for the goal of early diagnosis.(2)Hsa-miR-101-3p,hsa-miR-143-3p can be used as a differential biomarker for adenomyosis and uterine fibroids,endometrial polyps,and endometriosis.(3)Xuandan Sanjie Decoction and GnRH-a treatment can affect the expression of hsa-miR-101-3p and hsa-miR-143-3p in adenomyosis,and the differential miRNA is expected to become a combination efficacy observation indexo of traditional Chinese and Western medicine...