子宫脱垂患者阴道前壁Fibulin-3的表达及意义

EXPRESSION OF FIBULIN-3 IN UTERINE PROLAPSE AND ITS CLINICAL SIGNIFICANCE

目的探讨子宫脱垂(uterine prolapse,UP)患者阴道前壁中Fibulin-3 mRNA和蛋白的表达及其与子宫脱垂临床因素的关系。方法应用免疫组织化学S-P法及RT-PCR法对50例子宫脱垂患者的阴道前壁组织中Fibulin-3蛋白及mRNA水平表达进行测定,并与对照组20例(宫颈上皮内瘤变或妇科良性肿瘤行经阴道子宫全切术的非脱垂患者)组织对比,结合子宫脱垂的临床参数进行分析。结果免疫组化结果显示子宫脱垂组织中Fibulin-3蛋白表达的阳性率为52.0%(26/50),明显低于对照组85.0%(17/20),III+Ⅳ度子宫脱垂患者阴道前壁Fibulin-3蛋白阳性表达率明显低于I+II度子宫脱垂组(P=0.009),伴有压力性尿失禁(SUI)的子宫脱垂患者Fibulin-3蛋白表达较无SUI患者明显下降(P=0.004)。RT-PCR结果显示子宫脱垂患者阴道前壁组织中Fibulin-3 mRNA的相对表达量较对照组明显降低,且其含量与子宫脱垂的严重程度及是否伴有SUI相关,差异具有统计学意义。Fibulin-3蛋白和mRNA表达与患者阴道分娩次数无关(P值均>0.05)。结论Fibulin-3蛋白和mRNA在子宫脱垂患者阴道前壁组织中存在低表达,并与子宫脱垂的严重程度以及是否伴有SUI密切相关,Fibulin-3可能在子宫脱垂的发生发展中起重要的作用。

Objective To investigate the expression of Fibulin-3 mRNA and protein in the paries anterior vaginase of patients with uterine prolapse（UP）,and to examine its relationship with the clinicopathologic features.Methods Immunohistochemical staining was applied to determine Fibulin-3 expression in 50 cases of uterine prolapse and 20 cases of non-uterine prolapse tissue;RT-PCR analysis was used to examine the mRNA expression of Fibulin-3 in fresh prolapse and non-prolapse tissues;and the correlation of Fibulin-3 expression with clinical parameter was also analyzed.ResultsFibulin-3 protein positive expression rate in the uterine prolapse group was 52.0%（26/50）,significantly lower than the NON-UP group 85.0%（17/20）,P〈 0.05）;significantly lower in tissue of stages III＋Ⅳ than in stages I＋II（P=0.009）;and significantly lower in patients with stress urinary incontinence（P=0.004）.However,no statistical difference was found between the Fibulin-3 expression and the frequency of vaginal delivery（P〉0.05）.Fibulin-3 mRNA expression was much lower in 50 prolapse cases than in non-prolapse cases（relative optical density was 0.2759±0.1186 and 0.4787±0.0900 respectively,P=0.000） by RT-PCR analysis.Fibulin-3 mRNA expression was lower in uterine prolapse with stress urinary incontinence than in non-SUI cases（P〈0.05）,and lower in uterine prolapse of stages III＋Ⅳ than in stages I＋II（P〈0.05）.Fibulin-3 mRNA expression was not correlated with the frequency of vaginal delivery（P〉0.05）.ConclusionFibulin-3 mRNA and protein expressions are decreased in the anterior vaginal wall of UP,and changes in the Fibulin-3 expression may play an important role in the development of uterine prolapse.