乙酰肝素酶和促血管生成素2与子宫内膜异位症发病的关系

Expression of heparanase and angiopoietin-2 mRNA in endometriosis

目的探讨乙酰肝素酶(Hpa)和促血管生成素2(Ang2)基因在子宫内膜异位症(内异症)发生、发展中的作用。方法采用逆转录PCR(RT PCR)技术,检测86例内异症患者(内异症组,其中Ⅰ～Ⅱ期内异症患者25例,Ⅲ～Ⅳ期内异症患者61例)的异位和在位内膜组织及30例非内异症患者(对照组)的子宫内膜组织中HpamRNA和Ang2mRNA表达。结果(1)内异症组异位和在位内膜组织中,HpamRNA阳性表达率分别为62%(53/86)和55%(47/86),两者比较,差异无统计学意义(P>0.05);对照组内膜组织中HpamRNA阳性表达率为27%(8/30),明显低于内异症组,两组比较,差异有统计学意义(P<0.05)。(2)内异症组异位和在位内膜组织中Ang2mRNA的阳性表达率分别为71%(61/86)和65%(56/86),两者比较,差异无统计学意义(P>0.05);对照组内膜组织中Ang2mRNA的阳性表达率为33%(10/30),明显低于内异症组,两组比较,差异有统计学意义(P<0.05)。(3)Ⅰ～Ⅱ期内异症患者的异位及在位内膜组织中HpamRNA阳性表达率分别为44%(11/25)和32%(8/25),明显低于Ⅲ～Ⅳ期内异症患者异位与在位内膜组织的阳性表达率[69%(42/61)和64%(39/61)],两者比较,差异有统计学意义(P<0.05)。(4)Ⅰ～Ⅱ期内异症患者的异位及在位内膜组织中Ang2mRNA阳性表达率分别为60%(15/25)和64%(16/25);Ⅲ～Ⅳ期患者异位与在位内膜组织的阳性表达率分别为75%(46/61)和66%(40/61),不同期别内异症患者异位及在位内膜Ang2mRNA阳性表达率比较,差异无统计学意义(P>0.05)。(5)内异症组的异位内膜组织中HpamRNA与Ang2mRNA的表达呈显著正相关(P<0.05)。结论内异症患者异位和在位内膜组织中HpamRNA和Ang2mRNA均呈高表达,且二者呈正相关关系;推测Hpa和Ang2可能与内异症的发生和发展有密切关系。

Objective To investigate the relationship between heparanase （Hpa） and angiopoietin- 2 （Ang-2） gene expression and the development of endometriosis （ EM ）. Methods Expression of Hpa gene and Ang-2 mRNA in the eutopic and ectopic endometrium collected from 86 patients with endometriosis （ EM group） and the normal endometrium from 30 women without endometriosis （control group ） was determined by RT-PCR. Results （ 1 ） Hpa gene expression was detected in 53 ectopic endometrium and 47 eutopic endometrium specimens in the EM group and 8 normal endometrium specimens in the control group. There was no significant difference in Hpa gene expression between ectopic and eutopic endometrium in the EM group （P〉0.05 ）. However, the Hpa gene expression in normal endometrium in the control group was significantly lower than that in ectopic and eutopic endometrium in the EM group （P〈0.05 ）. （ 2 ） Ang-2 gene expression was detected in 61 ectopic endometrium and 56 eutopic endometrium specimens in the EM group and 10 normal endometrium specimens in the control group. There was no significant difference in Ang-2 gene expression between ectopic and eutopic endometrium in the EM group （P〉0.05 ） , however, the Ang-2 positive rate in normal endometrium in the control group was significantly lower than that in ectopic and eutopic endometrium in the EM group （ P〈0.05 ）. （ 3 ） The expression of Hpa gene in stage Ⅲ- Ⅳ endometriosis was significantly higher than that in stage Ⅰ-Ⅱ endometriosis （P〈0.05 ）. （ 4 ） The difference of Ang-2 mRNA expression between stage Ⅲ-Ⅳ and stage Ⅰ-Ⅱ endometriosis was not significant （P〉0.05 ）. （5） The expression of Hpa gene was shown to be significantly correlated to the expression of Ang-2 gene in ectopic endometrium specimens from patients with endometriosis （ P 〈0.05 ）. Conclusion Hpa and Ang-2 genes are highly expressed in both ectopic and eutopic endometrium of patients with endometriosis. Over-expression of these two genes may play a role in the development and progression of endometriosis.