Investigation On TCM Syndrome And Constitution Of Endometrial Polyp And The Immune Microenvironment Of Endometrial Polyps Based On PD-1/PD-L1

Background and ObjectiveBased on the statistics of the physique and TCM symptoms of endometrial polyps patients of childbearing age,this thesis explore the distribution between characteristics and relationship,meanwhile summarize the internal relationship and provide theoretical basis for the prevention and treatment of endometrial polyps by Chinese medicine.Combining the detection of various clinical specimens revealed the expression level of PD-1/PD-L1 in endometrial polyps and the data to analyze its significance,further explored the pathogenesis of endometrial polyps.Methods1.Clinical research:The general information and medical history of endometrial polyps patients who were hospitalized in the Department of Obstetrics and Gynecology of Jiangsu Province Traditional Chinese and Western Medicine Hospital from Feb.2019 to Feb.2020 were collected.Analyzing integrated data base on both the medical history and their constitutions counted by the physical questionnaire.2.Experimental Study:Blood samples,endometrial polyps and endometrial tissue samples were collected from patients' group with endometrial polyps that meet the eligibility criteria,Blood and endometrial tissue samples were collected from the control group.PD-L1 expression were localized and quantitatively analyzed in tissues by immunohistochemistry and Western blot.PD-1 expression in blood lymphocytes were detected by flow cytometry.In the meanwhile,Soluble PD-1 and soluble PD-L1 in serum were detected by ELISA.Results1.A total of 40 patients with endometrial polyps were included,with an average age of 38.73 ±8.21.The youngest was 23 years old and the oldest was 54 years old.2.50%of the patients came to the clinic because of "endometrial abnormalities detected by ultrasound,without other obvious clinical symptoms.The positive rate of ultrasound diagnosis was 67.5%;Most of the clinical symptoms are "prolonged menstrual period","intermenstrual bleeding" and "abnormal uterine bleeding".3.The type of Qi stagnation and blood stasis is the most common,with a total of 24 cases,accounting for 60%.The most peaceful,with a total of 24 cases,accounting for 60%.Statistical analysis shows that there is a significant correlation between the symptoms and constitution of patients with endometrial polyps.4.PD-L1 protein was found in both polyp tissues and tissues adjacent to polyps in patients with endometrial polyps,and the expression level of PD-L1 protein in polyp tissues was significantly higher than in polyp tissues.5.The expression levels of CD4+T lymphocytes and CD8+ T lymphocytes on the surface of patients with endometrial polyps before hysteroscopy were significantly higher than those in normal control group.The expression levels of PD-1 on B lymphocytes and monocytes were not different from those in the control group.The expression levels of CD4+ T lymphocytes and CD8+ T lymphocytes on the surface of patients after hysteroscopic surgery were significantly lower than before.6.The levels of sPD-1 and sPD-L1 in serum of patients with endometrial polyps before hysteroscopy were significantly higher than those in the control group.The serum levels of sPD-1 and sPD-L1 in patients undergoing hysteroscopic surgery were significantly lower than before.Conclusion1.Endometrial polyps can occur at any stage of childbearing age and have a certain recurrence rate.2.The onset is relatively insidious,and most of them have no clinical symptoms.Most of the clinical findings are "prolonged menstrial period","intermenstrual bleeding" and "abnormal uterine bleeding".Ultrasound diagnosis of vagina is currently relatively reliable and noninvasive Diagnostic tools.3.There is a clear correlation between the syndromes and physical fitness of patients with endometrial polyps,and the clinic may be able to achieve the purpose of treatment and prevention by adjusting the patient's physical bias.4.The high expression of PD-1/PD-L1 in polyp tissue and peripheral blood of patients with endometrial polyps indicates that the systemic and local immune microenvironment of patients with endometrial polyps is abnormal.The signal pathway of PD-1/PD-L1 may be involved in the development of endometrial polyps.The local endometrial cells of patients with endometrial polyps may escape the body's immune surveillance through this pathway,thereby promoting the endometrial polyps.5.To provide new ideas for treating endometrial polyps by inhibiting the PD-1/PD-L1 signaling pathway and other such widely used immunodetection and treatment strategies.