雌孕激素受体及转化生长因子β_1在宫腔粘连发病机制中的作用

The effects of transforming growth factor-β_1 and estrogen receptors on the mechanism of pathogenesis of intrauterine adhesions.

目的通过对子宫内膜组织中雌激素受体(ER)、孕激素受体(PR)及转化生长因子β1(TGF-β1)表达的研究,探讨宫腔粘连的发病机制。方法2002年7月至2003年12月首都医科大学附属复兴医院以前瞻性方法观察宫腔粘连组(观察组)和非宫腔粘连组(对照组)患者各30例,采用酶联免疫测定法,测定两组血清6项性激素:包括卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)、催乳素(PRL)、孕酮(P)及睾酮(T)。通过免疫组化半定量测定两组子宫内膜组织中ER、PR及TGF-β1的表达水平。结果两组血清性激素水平FSH、LH、E2、PRL、P及T差异无显著性意义(P>0·05);观察组子宫内膜TGF-β1和ER的表达明显高于对照组(P值分别为<0·01,<0·05);在观察组中重度宫腔粘连患者子宫内膜TGF-β1的表达明显高于轻、中度宫腔粘连患者,两者间子宫内膜TGF-β1表达差异有非常显著性意义(P<0·01);两组子宫内膜腺上皮细胞PR的表达差异无显著性意义(P>0·05)。结论子宫内膜组织中ER和TGF-β1的异常表达可能参与宫腔粘连的形成。

Objective To evaluate the possible mechanisms of pathogenesis of intrauterine adhesions （IUA） by investigating estrogen receptors （ER）, progesterone receptors （PR） and transforming growth factor-β1 （TGF-β1） expression in the endometrium. Methods We designed a prospective study on thirty patients with IUA as study group, and thirty women without IUA as control, all of them being treated in Fuxing Hospital Affiliatde to Capital University of Medical Sci- ences between 2002. 7 and 2003. 12. Follicle stimulating hormone （FSH） , luteinizing hormone （LH） , estradiol （E2 ） , prolactin （PRL） , progesterone （P） and testosterone （T） were examined by ELISA. Estrogen receptors （ER） , Progesterone receptors （PR） and transforming growth factor-β1 （TGF-β1） were examined by immuno-histochemical semi-quantitative analysis. Results There was no significant difference in FSH, LH, E2, PRL, P and T between the two groups （ P 〉 0. 05 ）. The expression of endometrial ER and TGF-β1 in the study group was extremely higher than those in the control group, and the statistical difference between the two groups were significant （ P 〈 0. O1 ）. TGF-β1 in severe IVA was siginficantly higher than those with moderate or mild IUA（ P 〈0. 01 ）. And there showed no significant difference in the expression of PR between the two groups （ P 〉 0. 05 ）. Conclusion The abnormal expression of endometrial estrogen receptors （ER） and TGF-131 may be relevant to the occurrence of IUA.