MMP-2与VEGF在子宫腺肌病中的表达和意义

Expression and significance of matrix metalloproteinase-2 and vascular endothelial growth factor in adenomyosis

目的:探讨MMP-2和VEGF在子宫腺肌病中的表达及在发病机制中的作用。方法:应用免疫组织化学法(SABC法)检测56例腺肌病子宫及26例正常子宫中MMP-2及VEGF的表达。结果:在异位内膜和在位内膜组中MMP-2的阳性表达率分别为71·4%和67·5%,均明显高于对照组正常内膜的42·3%(P<0·05)。异位内膜周围肌层和正常肌层中的阳性表达率分别为67·9%和34·6%(P<0·01);在异位内膜中VEGF的阳性表达率为75·0%,明显高于在位内膜和对照组正常内膜的52·5%和46·2%,(P均<0·05)。异位内膜周围肌层和正常肌层中的阳性表达率为69·6%和38·5%(P<0·05);在异位内膜和异位内膜周围肌层中MMP-2与VEGF的表达呈正相关(P均<0·01)。结论:异位内膜及内膜周围肌层中MMP-2的过度表达与子宫腺肌病病理过程中的内膜组织侵袭力和平滑肌大量增生有关,VEGF与腺肌病的血管生成密切相关,MMP-2和VEGF在子宫腺肌病的发生发展中有重要的协同作用。

Objective： To investigate the expression of MMP - 2 and VEGF in different parts of adenomyosis and the roles of these factors in the pathophysiology of uterine adenomyosis. Methods： 56 patients with histologically proved adenomyosis and 26 patients with normal uterus were adopted to detect expression of MMP - 2 and VEGF in endometrium and myometrium of uterus by immunohistochemical staining. Results： The positive expression rate of MMP-2 in ectopic and eutopic endometrium were 71. 4% and 67. 5%, respectively, were higher than that of normal endometrium （42. 3%, P 〈 0. 05）. The positive expression rates of MMP -2 in myometrium around the ectopic lesions was significantly higher than that of normal myometrium （67. 9% vs 34. 6% , P 〈 0. 01 ） ; The positive expression rate of VEGF in eutopic and normal endometrium were 52, 5% and 46. 2%, respectively, were significantly lower than that of ectopic endometrium （75%, P 〈0. 05）. The positive expression rates of VEGF in myometrium around ectopic lesions was significantly higher than that of normal myometrium （69. 6% vs 38. 5%, P 〈0. 05） ; The expression of MMP-2 was significantly correlated with VEGF in adenomyosis （P 〈 0. 01 ） . Conclusion： The overexpression of MMP-2 in endometrium and myometrium may be related to overgrowth of smooth muscle of uterus and invasiveness of endometrium tissue during progression of adenomyosis. The overexpression of VEGF have close relationship with adenomyosis angiogenesis. MMP - 2 and VEGF are two important factors involved in progression of adenomyosis.