| Objective: To investigate the changes and clinical significance of helper T cells 17(Th17)and regulatory T lymphocyte Treg cells and their major cytokines IL-17 and TGF-? before and after laparoscopic surgery in patients with ovarian endometriosis.Analyse its relationship with disease occurrence and surgical treatment.Methods: Thirty patients who underwent laparoscopic ovarian cyst removal in the West Coast Hospital of Qingdao University were selected as the observation group due to ovarian endometriosis(OEM).All patients were diagnosed as ovarian endometriosis by pathology.Cyst.The control group was 20 healthy women from the Qingdao Medical Examination Center.Peripheral blood was collected from the observation group before surgery,48 hours after surgery,and 1 month after surgery.Flow cytometry was used to detect the ratio of Th17 cells and Treg cells in peripheral blood.Serum interleukin IL-17 and TGF-? levels were measured by ELISA.The pathological grouping was to take the ectopic endometrial tissue during operation and the eutopic endometrial tissue as the observation group.The control group was normal endometrial tissue of patients with benign diseases who underwent hysteroscopy.The ratio of ROR?t and Foxp3 in ectopic endometrial tissue,eutopic endometrial tissue and normal endometrial tissue was determined by immunohistochemistry.Results:(1)The percentage of peripheral blood Th17 cells(18.78 ± 5.70)% in the observation group was significantly higher than that in the control group(11.87 ± 4.52)%(P <0.05);Th17 cells in the observation group 1 month after receiving laparoscopic surgery The level(13.56 ± 6.12)% was significantly lower than that before operation,and the difference was statistically significant(P <0.05).Compared with the control group,the Th17 cell level(13.56 ± 6.12)% of the observation group was 1 month after laparoscopic treatment.It was higher than the control group(11.87 ± 4.52)%,but the difference was not statistically significant(P = 0.296).(2)The percentage of preoperative Treg cells(3.70 ± 1.71)% in the observation group was significantly lower than that in the control group(5.54 ± 2.57)%(P <0.05);the observation group received 1 month of peripheral blood Treg cells after receiving laparoscopic surgery The percentage(4.77 ± 1.92)% was significantly higher than that before operation,and the difference was statistically significant(P <0.05).Compared with the control group,the percentage of Treg cells(4.77 ± 1.92)% in the observation group 1month after laparoscopic treatment was lower than that in the control group(5.54 ±2.57)%,but the difference was not statistically significant(P = 0.231)(3)The preoperative serum IL-17 concentration in the observation group(5.01 ±2.04)pg / m L was significantly higher than that in the control group(3.74 ± 1.54)pg / m L,the difference was statistically significant(P <0.05);48 hours after operation The concentration of-17(10.33 ± 4.56)pg / m L was higher than that before operation,but it was significantly reduced(2.79 ± 0.86)pg / m L 1 month after laparoscopic surgery,the difference was statistically significant(P <0.05).Compared with the control group,the pg/ m L(2.79 ± 0.86)pg / m L at one month after laparoscopic surgery was lower than the control group(3.74 ± 1.54)pg / m L,the difference was statistically significant(P <0.05).(4)The preoperative serum TGF-?(35.45 ± 12.51)ng / ml concentration in the observation group was lower than that in the control group(43.68 ± 12.53)ng / ml concentration.The concentration of TGF-? in the observation group at 48 hours after operation(38.38 ± 14.02)ng / ml was slightly higher than that before operation(35.45 ±12.51)ng / ml,but the difference was not statistically significant(P> 0.05).The concentration of TGF-?(50.81 ± 11.95)ng / ml 1 month after laparoscopic surgery was significantly higher than that before surgery,the difference was statistically significant(P<0.05).Compared with the control group,the concentration of TGF-?(50.81 ± 11.95)ng/ ml 1 month after laparoscopic surgery was higher than that of the control group(43.68 ±12.53)ng / ml,the difference was statistically significant(P <0.05).(5)ROR?t showed strong positive expression in ectopic endometrial tissues,with a positive rate of 86.66%,and ROR?t positive rate in eutopic endometrium was 16.66%.The difference between the two is statistically significant.The positive expression of ROR?t in the intimal tissue was 10.00%,and the difference was statistically significant compared with the ectopic endometrial tissue and the eutopic endometrial tissue.The overall positive rate of Foxp3 expression in ectopic endometrium was 90%,and the positive rate of eutopic endometrium was 26.66%.The difference between the two was statistically significant.The positive rate of Foxp3 in the normal endometrial tissue of the control group was 40%.The difference between the ectopic endometrial tissue and the eutopic endometrial tissue was statistically significant.Conclusions:(1)OEM samples showed high levels of expression in peripheral blood before undergoing laparoscopic surgery,and their factors and cell levels increased with the progression of the endometrial patients.This conclusion indicates that as an inflammatory disease of chronic progression,EMS may be associated with immune disease.after laparoscopic surgery,Th17 cells and subil-17 factors have reduced their expression level in peripheral blood(2)The expression level of both Treg cells and TGF-factor in peripheral blood is significantly reduced compared with the post-laparoscopic operation of the patients treated with laparoscopic surgery,and the expression level of Foxp3 in the endometrialtissue in the endometrium and in the endometrium.The distribution of peripheral tissues and the activation of the surrounding tissues resulted in an unequal distribution of peripheral blood in the samples of the Treg cells.(3)Th17/treg cells in the sample with peripheral blood and the expression imbalance in the ectopic tissue may be the cause of the disease.The correction of this immune imbalance is a new way of thinking about the treatment of endometriosis patients. |
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