利用小鼠模型研究子宫内膜异位症者在位内膜种植能力

Study on the Implanting Ability of the Eutopic Endometrium in Endometriosis with Mice Model

目的:探讨子宫内膜异位症(EMs)在位内膜异位种的植能力。方法:EMs组及非内异症(NEMs,宫颈原位癌)组患者各20例,分别取分泌晚期子宫内膜,再分别以0.2g、0.4g、0.6g种植量腹腔注射方法建成EMs小鼠模型,5d后处死,测量病灶大小,进行HE染色检测异位种植率及免疫组化法检测芳香化酶表达。结果:EMs组病灶数(3.9±0.3)高于NEMs组病灶数(3.2±0.1),P<0.05;0.2gEMs组种植率(60%)高于NEMs组(15%),P<0.01;0.4g的EMs组与NEMs组比较(100%vs85%)及0.6gEMs组与NEMs组比较(100%vs100%)无统计学差异,P>0.05。病灶体积:EMs组0.2g(2.3±0.7mm3)、0.4g(11.4±2.1mm3)、0.6g(21.6±3.4mm3)分别大于相应的NEMs组(0.4±0.2mm3、5.8±0.7mm3、12.0±2.5mm3),P<0.05。组内不同内膜种植量种植率比较0.2gvs0.4g,P<0.05;0.4gvs0.6g,P>0.05。光镜下未观察到EMs组与NEMs组人在位内膜有明显的形态学差异,鼠内异位病灶EMs组腺体结构较完整,NEMs组仅见少量残存的腺体细胞。芳香化酶表达EMs组在位内膜(2.10±1.12)及异位病灶(7.71±3.08)均高于NEMs组在位内膜(0)及异位病灶(5.80±3.01),P<0.05。结论:EMs在位内膜种植能力强于正常子宫内膜,芳香化酶能增强在位内膜的种植能力。

Objective： To explore the implanting ability of the endometrium in endometriosis with in vivo experiment. Methods： The women with endometriosis （EMs group） and without endometriosis （NEMs group） were both 20 cases. The eutopic endometrium in late secretory phase of each case was injected into the abdominal cavity of the mouse to establish endometriosis model. The injection dosage of endometrium was 0.2 g, 0.4 g and 0.6 g, separately. After 5 d the mice were killed. The endometriotic lesions were measured. The tissue morphology of the eutopic endometrium and endometriotic lesions was observed under the light microscopy and the expression of aromatase in them was detected by the immunohistochemistry method. Results： The amount of endometriotic lesions in EMs group （3.9 ± 0.3） was more than that in NEMs group （3.2 ±0.1）, P〈0.05; the implanting rates of EMs 0.2 g group （60%） was more than that of NEMs 0.2 g group （15%）, P〈0.01. There was no difference of the implanting rates between EMs 0.4 g group （100%） and NEMs 0.4 g group （85%）, EMs 0.6 g group （100%） and NEMs 0.6 g group（100%）, P〉0.05. The implantation rate compared in the same group： 0.2 g vs 0.4 g, P〈0.05; 0.4 g vs 0.6 g, P〉0.05.The volume of endometriotic lesions： EMs 0.2 g group （2.25 ± 0.69 mm^3）, EMs 0.4g group （11.43 ±2.14 mm^3）, EMs 0.6 g group （21.56 ± 3.40 mm^3）were separately more than NEMs 0.2 g group （0.38 ±0.21 mm^3）, NEMs 0.4 g group （5.83 ± 0.69 mm^3）, NEMs 0.6 g group （12.01± 2.46 mm^3）, P〈0.05; the differences of the volume in EMs group and NEMs group were 0.2 g vs 0.4 g： P〈0.05;0.4 g vs 0.6 g： P〈0.05.There was no significant difference in human eutopic endometrium between EMs group and NEMs group under light microscope. But the endometriotic lesions in EMs group had more integrated endometrium glands where the secretoration could be seen compared with those in NEMs group where had only few endometrium gland cells and with no integrated glands could be seen. Immunohistochemistry revealed： the expression of aromatase in eutopic endometrium of EMs （2.10 ± 1.12） and in endometriotic lesions （7.71±3.08） was both more than that in eutopic endometrium of NEMs （0） and in endometriotic lesions （5.80 ± 3.01）, P〈0.05. Conclusions： The implanting ability in the eutopic EMs is more intensive compared with that in the eutopic NEMs. Aromatase can enhance the implanting ability of eutopic endometrium of EMs.