不同类型子宫内膜异位症KGF及survivin的表达

Expressions of KGF and survivin in Endometriosis

目的:比较子宫腺肌症(AM)、卵巢子宫内膜异位症(OEMs)、角质细胞生长因子(KGF)、survivin蛋白表达的异同。方法:用免疫组化二步法分别检测40例正常子宫内膜、40例AM及34例OEMs患者的在位和异位内膜KGF、survivin的蛋白表达。结果:(1)本次入选对象KGF蛋白、survivin蛋白分别主要表达于子宫内膜间质细胞和腺体。(2)KGF表达在增殖期AM、OEMs在位内膜腺体均高于正常组,AM在位内膜高于异位内膜。分泌期AM、OEMs在位内膜腺体均高于异位内膜。增殖期AM在位及异位内膜间质、OEMs在位内膜间质中KGF表达均高于正常组,AM异位内膜、OEMs在位内膜间质KGF表达均高于OEMs异位内膜。分泌期仅见OEMs在位内膜间质中KGF表达高于OEMs异位内膜。(3)survivin表达在增殖期AM、OEMs异位内膜腺体均高于正常,AM异位内膜腺体高于在位内膜。分泌期AM在位、异位内膜腺体均高于正常,OEMs在位高于异位,AM在位、异位腺体均分别高于OEMs。AM在位内膜间质高于正常,OEMs在位内膜间质高于异位内膜。结论:在位内膜不同于正常内膜,在位内膜特性可能决定了不同类型异位内膜的发生。异位内膜凋亡减少则可能是疾病进展的前提之一。AM与OEMs具有不同的生物化学特征及临床表现,对局部雌孕激素反应不同,但存在相同的发病基础。

Objective： To investigate the expressions of keratinocyte growth factor （KGF）, survivin proteins in patients with adenomyosis （AM） and ovary endometriosis （OEMs）, respectively. Methods： A total of 114 samples were used in this study,including 40 adenomyosis and 34 ovary endometriosis of the ectopic and eutopic endometrium and 40 normal endomtrium tissues, using immunohistochemistry method to examine the expressions of survivin and KGF proteins. Results： KGF proteins mainly expressed in the stromal cells whereas survivin protein expressed in the glandular cells. There was a higher expression of KGF in glandular cells of the eutopic endometrium in AM and OEMs than those in the normal endometrium. There was a higher expression KGF in AM in the eutopic glandular cells than that in the ectopic endometrium in the proliferative phase. In the secretive phase, glandular cells expressed higher KGF protein in the eutopic endometrium than that of the ectopic endometrium both in AM and OEMs. The KGF protein level in the stromal cells of the eutopic and the ectopic endometrium in AM and the eutopic endometrium in OEMs were higher than that of the normal endometrium. The stromal cells also expressed higher KGF in the ectopic endometrium in AM and eutopic endometrium in OEMs than that of the ectopic stromal cells in OEMs. KGF level in the eutopic stromal cells increased more than the ectopic stromal cells in OEMs. As in the aspect of survivin expression,the ectopic glandular cells in AM and OEMs increased more than that of normal cells apart from the higher level in the ectopic glandular cells than the eutopic ones in AM in the proliferative phase. In the secretive phase ,both the eutopic and ectopic glandular cells in AM expressed higher survivin protein level than those of normal endometrium and OEMs＇. The eutopic stromal cells of AM also expressed higher survivin protein level than that of normal endometrium. Both glandular cells and stromal cells of the eutopic endometrium in OEMs expressed higher survivin level than that of the ectopie endometrium. Conclusion： There was deference between eutopic and normal endometrium both in AM and OEMs. The character of the abnormal eutopic stromal cells may initiate the formation of AM and OEMs. Higher anti-apoptotic activity in ectopic tissues may improve the disease. AM and OEMs may have common background in pathogenesis although they played different biochemical and clinical phenomenon.