CXCL5、MMP-9在宫腔粘连子宫内膜组织表达及其临床意义

Expression and role of CXCL5 and MMP-9 in endometrial tissue of IUA patients

目的研究细胞趋化因子配体-5(CXCL5)和基质金属蛋白酶-9(MMP-9)在宫腔粘连(IUA)子宫内膜组织中的表达及临床意义。方法收集48例IUA患者,予以实施宫腔粘连分离术(TCRA),术中获取子宫内膜组织,术后一个月复查宫腔镜,评估手术效果的同时再次获取子宫内膜组织。同期行宫腔镜检查排除子宫内膜病变的48例女性为对照组。免疫组化测定CXCL5、MMP-9在子宫内膜组织的相对表达,使用Western blot检测其蛋白相对表达,RT-PCR检测mRNA表达情况。结果 48例IUA在TCRA术后宫腔形态恢复较好,1例粘连较重,再次TCRA手术。免疫组化结果显示:CXCL5、MMP-9在IUA组相对表达低,在IUA术后组表达增加,但两组的表达量均低于对照组,3组之间的差异有统计学意义(P<0.01);Western blot及RT-PCR检测结果显示,IUA组子宫内膜CXCL5、MMP-9蛋白及mRNA表达量均低于IUA术后组,并且两组都低于对照组。3组之间的差异有统计学意义(P <0.05);CXCL5与MMP-9表达存在相关性,且呈一致性变化。结论 CXCL5、MMP-9在IUA子宫内膜中呈低表达,在IUA患者术后子宫内膜中增加,CXCL5影响MMP-9水平,CXCL5和MMP-9可能参与了IUA发生。

Objective To explore the expression and clinical significance of CXC cell chemokine ligand-5(CXCL5)and matrix metalloproteinase-9(MMP-9)in intrauterine adhesion(IUA)endometrial.Methods Endometrial tissue was obtained from 48 patients who underwent IUA.The transcervical resection of adhesions(TCRA)was performed,and the surgical effect was evaluated by hysteroscopy one month after TCRA.Endometrial tissue was obtained again during hysteroscopy.48 women who underwent hysteroscopy to exclude endometrial disease during the same period served as a control group.Immunohistochemistry was performed to determine the relative expression of CXCL5 and MMP-9 in endometrial tissue.Western blot was used to detect the relative expression of protein,and RT-PCR was used to detect the relative expression of mRNA.Results The uterine cavity of 48 patients with IUA recovered well after TCRA surgery,and 1 patient had severe adhesion.TCRA surgery was performed again.The results of immunohistochemistry showed that CXCL5 and MMP-9 were relatively low in the IUA group and increased in the IUA postoperative group,but the expression levels of the two groups were lower than those of the control group,and the difference among the three groups was statistically significant(P<0.01).Western blot and RT-PCR results showed that the expression levels of CXCL5,MMP-9 protein and mRNA in the endometrium of the IUA group were lower than those of the IUA postoperative group,and both groups were lower than the control group.The difference between the three groups was statistically significant(P<0.05);the expression of CXCL5 and MMP-9 were correlated and showed consistent changes.Conclusion CXCL5 and MMP-9 are low expression in the endometrium of IUA,and increase in the endometrium of IUA patients after transcervical resection of adhesions.CXCL5 affects the level of MMP-9,and CXCL5 and MMP-9 may be involved in the occurrence of the IUA.