子宫内膜和腺肌病中间丝蛋白及肌动蛋白的免疫组化表达

Immunohistochemical expressions of the intermediate filament proteins and the actin in endometrium and adenomyosis.

目的:比较子宫内膜及腺肌病腺上皮和间质的分化能力与分化方向。方法:用免疫组化ABC法检测20份不同生殖周期子宫内膜和腺肌病组织标本的角蛋白、波形蛋白、结蛋白及肌动蛋白α亚单位的表达情况。结果:腺肌病与子宫内膜腺上皮具有相似的角蛋白表达率,达70%～90%,不受腺体分泌状态的影响;腺上皮波形蛋白表达率为80%～90%,在分泌期下降到60%(P<0.05),且主要局限于基底层和表面上皮;主要表达波形蛋白间质细胞,在腺肌病为80%,显著高于子宫内膜的35%(P)<0.01)。此外,间质细胞有5%～15%可以表达角蛋白、结蛋白和肌动蛋白。结论:腺肌病中腺上皮在分化上相当于子宫内膜基底层和表面上皮性质,波形蛋白的高度表达是内膜样分化的标记。间质细胞具有多向分化潜能,对腺上皮的发生和腺肌病的形成有作用。

Objective To compare the differences of immunohistochemical expressions between the eutopic endometrium and the ectopic adenomyosis foci including endometrium Methods Twenty of samples of Patients with adenomyosis and their eutopic endometrium were immunohistochemically determinated by a panel of monoclonal antibodies specific for keratin, vimentin, desmin and alpha smooth muscle actin. Results There were very similar expressive status for the keratin between the endometrium and the adenomyosis, occuring in 70% to 90% respectively. Their positive expressions were not affacted by the secretory state of glands. The expressive rates of vimentin in the glandular epithelium were 80% to 90%, but significantly decreased to 60% with the glandular secretion (P<0.05). The immunoreactivity for vimentin was localized in the base and the surface of epithelium. The stromal cells for vimentin positive were 80% in the adenomyosis, and significantly increased in comparison with that in the eutopie endometrium (35%) (P<0.01). Some stromal cells expressed in desmin and actin about 5% to 15%. Conclusions The functional differentiation of the ectopic endometrium in adenomyosis is similar to the base and the surface of epithelium in the eutopic endometrium. The high immunoreactivity for vimentin is a marker of endometrioid differentiation. The stromal cells may be multiple differentiation potential and play a role in the histogenesis of the epithelium and form the gross features of adenomyosis.