凋亡相关蛋白Bcl-2/Bax与子宫内膜异位症的相关性研究

Relationship of apoptosis and its regulating protein Bcl-2,Bax expression to pathogenesis of endometriosis.

目的研究子宫内膜异位症(内异症)及子宫腺肌症患者在位及异位内膜组织中细胞凋亡相关蛋白Bcl-2、Bax表达及其凋亡率比较。方法采用免疫组化法检测各组织标本中Bcl-2、Bax的表达,流式细胞仪测定各组织的细胞凋亡率。结果(1)在正常和正位内膜组织中,Bcl-2或Bax表达相同(P>0.05),具有明显周期性变化,均为增生期高于分泌期(P<0.05);(2)子宫腺肌病和腹壁异位内膜中,Bcl-2或Bax均持续表达,无周期性变化(P>0.05);(3)卵巢内异症的异位内膜,Bcl-2和Bax极少表达;(4)流式结果显示正常子宫内膜、在位内膜凋亡率与异位内膜组织凋亡率有显著性差异(P<0.05)。结论①Bcl-2或Bax在正常和在位子宫内膜的周期性表达,提示它们可能参与月经周期调节;②子宫腺肌病及腹壁异位内膜腺上皮细胞Bcl-2持续存在,使之得以长期增殖而发病;③卵巢内异症极少表达Bcl-2可能是促成细胞凋亡形成,引起巧克力囊肿的原因。

Objective： To investigate the apoptosis regulating protein Bcl -2 and Bax expression in endometrium with non endometriosis （control）, eutopic endometrium and ectopic endometrium with EMS in abdominal wall endometriosis, ovarian endometriosis and adenomyosis respectively. Methods： The expressions of Bcl - 2, Bax of these samples were investigated by immunohistochemical assay. Cell apoptosis in each endometrial tissures was determined by flow cytometry. Results ： The expression of Bcl - 2 or Bax in the eutopic endometrium was the same as the normal endometrium, showing obvious cyclic changes. An increased expression of Bcl - 2 and Bax was found in proliferative eutopic endometrium of healthy controls than secretory endometrium （ P 〈 0. 05）. The Bcl - 2 and Bax expression in adenomyosis and in abdominal wall endometriosis was not the cyclic change. Less expression of Bcl - 2 and Bax was found in the ovarian endometriosis. There was significant difference of apoptosis rate among control, eutopic endometrium and ectopic endometrium （ P 〈 0. 05）. Conclusions： ①The Bcl -2 and Bax cyclic change may play an important role in the proliferation and physiologic death of normal and eutopic endometrial glandular epithelial cells.②Bcl - 2 may play an important role in forming adenomyosis and abdominal wall endometriosis.③ Bcl - 2 may be the cause of forming chocolate cyst by prompting apoptosis.