子宫内膜异位症淋巴细胞亚群分布研究

Distribution of lymphocyte subsets in ectopic and eutopic endometrium during endometriosis

目的:本研究检测子宫内膜异位症(EMs)患者在位和异位内膜组织中CD45RO,CD4和CD8阳性的T淋巴细胞数量表达,探讨免疫细胞在EMs中的作用,为免疫治疗提供依据。方法:采用CD45RO,CD4和CD8单克隆抗体,应用免疫组织化学法标记EMs患者的在位和异位子宫内膜组织中CD45RO,CD4和CD8阳性细胞,观察其分布特点并计数其密度,并与正常妇女子宫内膜对照。结果:EMs组和正常对照组的增殖期与分泌期子宫内膜组织中均存在CD45RO,CD4和CD8阳性的淋巴细胞,EMs组在位和异位内膜中CD45RO,CD8阳性细胞数量均高于对照组,差异有统计学意义(P<0.05),且在异位内膜中的表达较在位内膜升高,差异具有统计学意义(P<0.05);在位和异位内膜中CD4阳性细胞较对照组略有升高,差异无统计学意义(P>0.05);在位和异位内膜中CD4/CD8的比值均较对照组降低,差异有统计学意义(P<0.05);在位和异位内膜之间比较CD4阳性细胞、CD4/CD8的比值无明显变化,差异无统计学意义(P>0.05)。在位内膜的CD45RO,CD4和CD8阳性细胞表现为由增殖期到分泌期增加的趋势,但差异无统计学意义(P>0.05);异位内膜中CD45RO,CD4及CD8阳性细胞无明显增殖期与分泌期的改变(P>0.05);对照组中CD45RO及CD4阳性细胞从增殖期到分泌期有增多的趋势,但差异无统计学意义(P>0.05)。EMs组异位和在位内膜Ⅰ～Ⅱ期病例和Ⅲ～Ⅳ期病例之间CD45RO,CD4和CD8阳性细胞未发现明显变化,差异无统计学意义(P>0.05)。结论:EMs患者在位和异位内膜中T淋巴细胞亚群分布的改变为EMs的发生提供条件,并对EMs的发生、发展和维持起重要作用。

Objective： The purpose of this study was to assess the population of CD45RO＋, CD4＋, and CD8T-lymphocytes in eutopic and ectopic endometrium in women with endometriosis, and to explore the role and activity of immunocytes in endometriosis, and their relevance to immunotherapy. Methods： Monoclonal antibodies against CD45RO, CD4, and CD8 were used for immunohistochemical staining to indicate positive cells in eutopic and ectopic endometrial tissues of women with endometriosis. The distribution and density of the different lymphocyte populations was compared with normal endometrium from healthy controls. Results： While lymphocytes staining positive for CD45RO, CD4, CD8 were present in the proliferative and secretory endometrium of tissues from both the endometriosis and control groups, there was a higher percentage of positive lymphocytes in tissues from the endometriosis group （P 〈0.05）, and the percentage of positive lymphocytes in tissues from the ectopic endometriosis group was greater than from the eutopic endometriosis group （P 〈0.05）. CD4 positive cells were also slightly increased in the ectopic and eutopic endometriosis groups compared with the control group, but this difference was not statistically significant （P〉0.05）. The ratio of CD4＋/CD8＋ lymphocytes in the eutopic and ectopic endometrium was lower than in the control group （P 〈0.05）; however, there were no significant differences in the percentage of CD4 positive cells or the ratio of CD4＋/CD8＋ cells between the eutopic and ectopic endometrial tissue samples （P 〉0.05）. There was also a slight （but not significant） increase in the percentage of CD45RO＋, CD4＋, and CD8＋ cells during the transition from the proliferative phase to the secretory phase in eutopic endometrium. There was also no significant difference in CD45RO, CD4, and CD8 expression in ectopic endometrium and normal control endometrium during the transition from the proliferative phase to the secretory phase. Finally, there were no significant differences in the number of CD45RO~, CD4~, or CD8~ cells in two cases of stage I/II and III/IV disease （P 〉0.05）. Conclusion： The distribution of T-lymphocyte subsets in eutopic and ectopic endometrium are related to the progression of endometriosis, and immunotherapy targeting specific sub-sets of lymphcytes may be useful for the treatment of endometriosis.