抑癌基因PTEN在子宫内膜异位症发生发展中的作用

Role of tumor suppressor gene PTEN in pathogenesis of endometriosis

目的 :检测第 10号染色体缺失的磷酸酶和张力蛋白同源物基因 (PTEN)在子宫内膜异位症 (EMS)中的表达 ,探讨其在EMS发病机制中的作用 .方法 :收集EMS患者子宫内膜病灶 37(卵巢巧克力囊肿 2 0 ,子宫肌腺症 17)例和正常子宫内膜 33例 ,采用原位杂交技术检测PTENmRNA在异位内膜组织中的定位和表达强度 ,并比较PTEN基因表达与EMS临床分型的关系 .结果 :PTENmRNA主要表达于腺体细胞的胞质中 ;与正常子宫内膜相比 ,PTEN基因在异位内膜组织中的表达显著降低 (4 8.6 %vs93.9% ,P =0 .0 0 0 2 ) ;PTENmRNA的表达呈明显的周期性改变 ,在增殖期内膜呈低水平表达 ,分泌期表达增加 ,但这一差异仅在正常子宫内膜组织中有意义 (P=0 .0 10 2 ) ;PTENmRNA的表达水平随临床分期的增加而降低(P =0 .0 0 2 6 ) ;但在子宫肌腺症和卵巢巧克力囊肿组织中 ,PTEN基因表达水平无差异 (5 5 .0 %vs 5 2 .9% ,P =0 .4 0 18) .结论 :PTENmRNA表达水平的降低可能是EMS的发病机制之一 .

AIM: To investigate the expression of phosphatase and tension homologue deleted on chromosome 10, the tumor suppressor gene PTEN, in ectopic endometrium in patients with endometriosis and to study the role of PTEN in the pathogenesis of the disease. METHODS: The expression of PTEN in ectopic endometrium in 37 patients with endometriosis, including 20 ovarian endometriosis and 17 adenomyosis patients, was analyzed by using in situ hybridization method. Thirty-threc patients with uterine myoma were taken as controls. RESULTS: The PTEN expression level in the ectopic endometrium decreased significantly as compared with that in the controls (48.6% vs 93.9%, P=0.0002), and all the positive signals were mainly seen in the cytoplasm. The gene expression showed a cyclic change both in patients with endometriosis and in controls. The PTEN staining was found to be more frequent in secretory phase than in proliferative phase. But the difference was statistically significant only in the control group (P= 0.0102). The PTEN positivity rate in the patients with adenomyosis was 55.0% and in those with ovarian endometriosis was 52.9%. No significant difference was found between the two groups (P=0.4018). The expression of PTEN mRNA was significantly correlated with the stage of the endometriosis (P= 0.0026). CONCLUSION: The change of the PTEN expression may be involved in the pathophysiology of endometriosis.