子宫内膜异位症异位与在位内膜发育日期及雌、孕激素受体水平

HistologicExaminationandImmunohistochemicalAnalysisofEstrogenandProgesteroneReceptorsofEutopicandEctopicEndometriuminPatientswithEndometriosis

目的：探讨子宫内膜异位症的发病机理。方法：对２８例子宫内膜异位症的在位内膜和异位内膜进行病理组织学发育日期评定，对其中１５例采用免疫组化ＡＢＣ法测定雌激素受体（ＥＲ）、孕激素受体（ＰＲ）水平，并进行比较。结果：异位内膜较在位内膜发育落后的有１９例（６７．９％），提前的４例（１４．３％），仅５例（１７．９％）相符合；ＥＲ、ＰＲ水平异位内膜较在位内膜低，在腺体细胞中的差别有显著性（Ｐ＜０．０１，Ｐ＜０．０５），在间质细胞中无明显差别（Ｐ＞０．０５）。结论：免疫组化ＡＢＣ法可对受体定位，在异位内膜ＥＲ、ＰＲ研究上优于葡聚糖活性碳吸附（ＤＣＣ）法，异位内膜不同于在位内膜可能与发病机理及局部激素环境有关。

Objective:Tostudythediferencesofhistologicdatingandsteroidreceptorsbe-tweenectopicandeutopicendometriuminpatientswithendometriosis.Methods:Histologicexamina-tionsweredoneoneutopicandectopicendometriumin28patientswithpelvicendometriosis,andes-trogenandprogestronereceptorsconcentrationsweredeterminedbyimmunochemicalABCmethodin15patients.Altheectopictissueswerebiopsiedfromperitoneallesions.Results:In67.9%pa-tients,theectopicendometriumdevelopmentwasretardatedand14.3%acceleratedascomparaedwitheutopicendometrium,andonly17.9%identical.Theestrogenreceptors(ER)andprogesteronereceptors(PR)contentsofectopicendometriumweresignificantlylowerthanthoseofeutopicen-dometriuminglandularcels(P<0.01,P<0.05respectively),whiledifferenceswerenotsignificantinstromacels.Conclusions:Theadvantageoftheimmunochemicaltechniqueisthatitcandefinitelylocatethesiteofreceptorsinthehistologicsection.ThediferenceinhistologicdatingandERandPRconcentrationsintheeutopicandectopicendometriummaybeaccountedforbythediferentsteroidenvironmentsandpathogenictheoryofperitoneummetaplasia.