细胞增殖核抗原和凋亡抑制蛋白在子宫内膜异位症中的表达和意义

Expression and Significance of PCNA and Survivin in Endometriosis

目的检测细胞增殖核抗原(proliferatingcellnuclearantigen,PCNA)和凋亡抑制蛋白(Survivin)在子宫内膜异位症(内异症)中的表达,探讨内异症的发病机制。方法采用免疫组化法,检测内异症患者在位、异位内膜PCNA和Survivin的表达,正常子宫内膜作对照。结果内异症组PCNA和Survivin的表达均高于对照组(P<0.05);PCNA的表达与对照组月经周期呈直线负相关(P<0.05);其在内异症组在位内膜分泌期的表达强于对照组分泌期(P<0.05);Survivin的表达与内异症组在位内膜月经周期呈直线正相关(P<0.05);其在内异症组在位内膜增生期和分泌期的表达均强于同期对照组(P<0.05);PCNA和Survivin在Ⅲ、Ⅳ期内异症患者异位内膜的表达强于Ⅰ、Ⅱ期(P<0.05),并与R-AFS临床分期呈直线正相关(P<0.05)。结论子宫在位内膜细胞增殖和抗凋亡能力的增强在内异症的发生发展中起重要作用;PCNA的增殖和Survivin的抗凋亡作用分别在正常子宫内膜和内异症在位内膜的周期性调节中起重要作用;PCNA和Survivin与内异症病情的严重程度密切相关。

[Objective] To detect the expression of proliferating cell nuclear antigen （PCNA） and Survivin in endometriosis, so as to investigate the pathogenesis of endometriosis. [Methods] Immunohistochemical Strept Avidin Biotin Complex methods was used to examine the expression of PCNA and Survivin in the eutopic and ectopic endometrium of endometriosis, and compare with normal endometrium. [Result] The expression of PCNA and Survivin in endometrium of endometriosis was higher than that in normal endometrium. In control group endometrium the level of PCNA had a negative correlation with menstrual cycle. The level of PCNA in secretory phase of eutopic endometrium of endometriosis was higher than that in secretory phase of control group. The Survivin expression in eutopic endometrium of endometriosis had a positive correlation with menstrual cycle. The level of Survivin in proliferative and secretory phase of eutopic endometrium of endometriosis were respectively stronger than that in same phase of control group. The expression of PCNA and Survivin in ectopic endometrium in stage Ⅲ, Ⅳ patients with endometriosis was higher than that in stage Ⅰ , Ⅱ, which had positive correlation with R-AFS clinical staging of endometriosis. [Conclusions] The reinforcement of cell proliferation and anti-apoptosis in eutopic endometrium of endometriosis plays an important role in the occurrence and progression of endometriosis. The proliferative action of PCNA and the anti-apoptosis action of Survivin respectly play an crucial role in normal menstrual cycle and in menstrual cycle of eutopic endometrium of endometriosis. The expression of PCNA and Survivin is closely relavent to the severity of endometriosis.