The Role of Cytokines in Peritoneal Fluid of Patients with Endometriosis and Adenomyosis Associated Infertility

Objective:To analyze the levels of cytokines in peritoneal fluid of patients with endometriosis and adenomyosis associated infertility to investigate the role of cytokines in the pathogenesis of endometriosis and adenomyosis associated infertility.Methods:86 patients,who underwent laparoscopy for confirmation of endometriosis and adenomyosis associated infertility from Jan.2008 to Dec.2009,were recuited in this study.The concentrations of cytokines in peritoneal fluid including interferon(IFN)-γ、tumour necrosis factor(TNF)-α、vascular endothelial growth factor(VEGF) and interleukin(IL)-6、10、17 were measured by luminex multiplex analysis and the correlations between these cytokines and stages of disease were analyzed.Results:57 patients,confirmed by surgery and histology,were acturally selected in the study.They were divided into four groups: 13 cases with stage Ⅰ～Ⅱ endometriosis(mild group) 、14 cases with stage Ⅲ～Ⅳ endometriosis(severe group)、13 cases with adenomyosis(adenomyosis group)、17 cases with endometriosis and adenomyosis(coexisting group) and 26 cases of normal pelvis in control group.Except IFN-γ,the levels of the other five cytokines(TNF-α、IL-6、IL-10、IL-17、VEGF) in five groups were significantly different.The results of mutual comparison among these five cytokines: ①the levels in mild and severe group were significantly higher than those in control group(P0.05),while there were no differences between mild and severe group(P0.05);②the levels of the five cytokines in adenomyosis group were similar to those in control group(P0.05).the levels of TNF-α、IL-6、IL-17 were lower than those in mild and severe group(P0.05),the level of VEGF was lower than that in severe group(P0.05);③the levels of the five cytokines in coexisting group were significantly higher than those in adenomyosis and control group(P0.05),while there were no significant differences among coexisting、mild and severe group(P0.05).Conclusions:The abnomal concentration of cytokines in pelvic cavity of patients with endometriosis lead to the change of pelvic environment,which possibly disturbs the process of normal fertility.The pathogensis of adenomyosis associated infertility is not associated with cytokines in pelvic environment,which is different from the pathogenesis of endometriosis.