Expression Of Ninj1,PGP-9.5 And IL-1β In Endometriosis And Adenomyosis And Their Correlation With Dysmenorrhea

Objective:The expression of Injury-Induced Protein 1(Ninj1),Interleukins-1β(IL-1β)and protein gene product 9.5(PGP-9.5)was measured in endometriosis(EMT)and adenomyosis(AD).To identify new molecular targets for endometriosis and adenomyosis,and to provide theoretical basis for effective prevention and treatment of endometriosis and adenomyosis pain.Methods:Patients who underwent gynecological surgery at the Affiliated Hospital of Qingdao University from April 2020 to April 2021 were selected for the study.Forty patients with ovarian endometriosis(OEM)were selected as the OEM group,and 20 of them with in situ endometriosis(15 patients who underwent hysterectomy+bilateral salpingo-oophorectomy + ovarian cyst debridement due to uterine fibroids and ovarian cysts;5 patients who underwent combined hysterolaparoscopy for infertility due to ovarian endometriosis cysts)were collected,and according to The dysmenorrhea group was divided into dysmenorrhea subgroup and non-dysmenorrhea subgroup,20 cases each;the abdominal wall endometriosis group was 20 patients with abdominal wall endometriosis,and the AD group was 40 patients with adenomyosis,divided into dysmenorrhea subgroup and non-dysmenorrhea subgroup,20 cases each,according to the presence or absence of dysmenorrhea;patients who underwent hysterectomy with postoperative pathology of uterine fibroids without pain were selected as the control group.The expression and correlation of three proteins,Ninj1,IL-1β and PGP-9.5,were detected by immunohistochemical staining,and the expression level of IL-1 β in peripheral blood was detected by enzyme-linked immunosorbent assay.Results:(1)OEM group compared with the control group:(i)IL-1 β expression level in peripheral blood was higher in the OEM group(9.47±0.62 pg/ml)than in the control group(8.55 ± 0.72 pg/ml),and the difference was statistically significant(t=-4.184,P<0.05);(ii)Ninj1,PGP-9.5 and IL-1 β protein in ectopic endothelium and in situ endothelium in the OEM group expression were all increased,and the differences were all statistically significant(χ2= 19.394,19.200,17.653;4.800,4.800,4.286,P<0.05).(2)Compared with the OEM in situ endothelial subgroup: the expression of all three proteins was higher in the ectopic endothelial subgroup than in the in situ endothelial subgroup,and all differences were statistically significant(χ2= 5.272,5.000,4.149,P=0.022,0.02,0.042).(3)In the OEM group non-dysmenorrhea subgroup compared with the dysmenorrhea subgroup:(i)the expression level of IL-1β in the OEM peripheral blood non-dysmenorrhea subgroup was(9.47±0.49pg/ml)and the expression level of IL-1β in the dysmenorrhea subgroup was(9.46±0.75pg/ml),and the difference between them was not statistically significant(t=0.055,P=0.957);(ii)the OEM dysmenorrhea Ninj1 and PGP-9.5 protein expressions were higher in the subgroup than in the non-dysmenorrhea subgroup,and the differences were statistically significant(χ2=8.533,11.905,both P<0.05);the differences in IL-1β protein expression between the two subgroups were not statistically significant(χ2=0.114,P>0.05).(4)In the AD group compared with the control group:(i)the expression level of IL-1β in peripheral blood was higher in the AD group(9.92±0.75pg/ml)than in the control group(8.55±0.72pg/ml),and the difference was statistically significant(t=-6.229,P=0.000);(ii)the expression of all three proteins in lesions and in situ endothelium was higher in the AD group than in the control group,and the differences were statistically significant(χ2 =14.700,22.634,14.848;3.384,3.704,4.375,all P<0.05).(5)Compared with the AD in situ endothelial subgroup: all three protein expressions were higher in ectopic lesions than in situ endothelium,and all differences were statistically significant(χ2= 5.051,11.429,4.053,P = 0.025,0.001,0.044).(6)In the non-dysmenorrhea subgroup of the AD group compared with the dysmenorrhea subgroup:(i)the expression levels of IL-1β in peripheral blood were(9.7±0.72pg/ml)in the AD non-dysmenorrhea subgroup and(10.07±0.76pg/ml)in the dysmenorrhea subgroup,and the expression between them was not statistically significant(t=1.199,P=0.239);(ii)the expression levels of Ninj1 and PGP-9.5 protein expressions were higher in the subgroup than in the non-dysmenorrhea subgroup,and the differences were statistically significant(χ2=13.789,4.800,P<0.05);IL-1β protein expression between the two subgroups,the differences were not statistically significant(χ2=1.707,P=0.102).(7)Three protein expressions were higher in the abdominal wall EMT patients than in the control group,and the differences were statistically significant(χ2=8.640,4.949,6.416,all P<0.05).(8)The expression of Ninj1 was positively correlated with PGP-9.5(r=0.733,P<0.05)and Ninj1 was also positively correlated with IL-1β(r=0.628,P<0.05)in the immunohistochemistry of EMT group.(9)Ninj1 was positively correlated with PGP-9.5(r=0.626,P<0.05)and Ninj1 was positively correlated with IL-1β(r=0.448,P<0.05)in the immunohistochemistry of AD group.Conclusion:(1)Overexpression of Ninj1,IL-1β and PGP-9.5 in patients with endometriosis,abdominal wall endometriosis and adenomyosis may be associated with the development of endometriosis and adenomyosis.(2)Ninj1 is involved in the development of painful symptoms in patients with endostosis and adenomyosis,and PGP-9.5 may correlate with the degree of pain.