子宫内膜胞饮突的形成与雌孕激素及其受体的关系

The relation between formation of pinopodes in human endometrium and estrogen/progesterone and their receptors

目的:观察排卵正常的妇女子宫内膜接受性标志物—胞饮突的形成情况;研究胞饮突的发育与雌、孕激素及其受体的关系。方法:(1)对27名妇女进行阴道B超结合检测尿LH监测排卵。(2)于尿LH+3～11天随机进行1次子宫内膜活检,标本一部分行扫描电镜观察胞饮突,另一部分采用免疫组化技术检测子宫内膜上雌、孕激素受体(ER、PR)的表达。(3)活检日静脉采血3ml,用磁性分离酶联免疫法检测血清雌、孕激素。结果:(1)按扫描电镜下所见超微结构特点将子宫内膜分为胞饮突发育之前、发育中、成熟的和退化的胞饮突四个阶段;(2)胞饮突的发育与血清孕激素水平呈正相关关系(r=0.515,P<0.01);(3)胞饮突发育后,PR在腺上皮的表达明显下降,而在间质中的表达无明显变化;腺上皮PR水平与血清孕激素水平呈负相关(r=-0.550,P<0.01),与胞饮突的发育有负相关关系(r=-0.793,P<0.01);(4)未发现胞饮突的发育与ER、雌激素水平有相关性。结论:孕激素水平升高与胞饮突发育和腺上皮孕激素受体水平下调同步,孕激素通过调节PR参与对胞饮突发育的调控。

Objective：To observe the formation of pinopodes in human endometrium in ovulation normality cycles and to investigate the relation between the development of endometrial pinopodes and the estrogen/progesterone and their receptors. Methods： （1）Twenty-seven women were followed for one cycle by vaginal ultrasonograms, and by testing urine samples for LH surge. （2）An endometrial biopsy sample was obtained randomly between days 3 to 11 after the LH surge and divided into two pieces, one for scanning electron microscopy and the other for immunohistochemistry. The biopsy samples were analyzed for expression of estrogen and progesterone receptors （ER, PR）by using immunohistochemical techniques. （3）Serum samples were obtained on the biopsy day and determined the concentrations of estradiol and progesterone by magnetic solid phase enzyme immunoassay. Receptor expression was compared with hormone levels and the developmental stage of the pinopodes. Results： （1）Biopsy samples were grouped according to developmental stage of the endometrium as determined by scanning electron microscopy,which were defined as before pinopodes, developing pinopodes, fully developed pinopodcs and regressing pinopodes. （2）The development of pinopodes was positively correlated with the progesterone level（r=0.515, P〈0.01）. （3）The expresstion of PR in stromal ceils did not change during iuteal period. PR in the glandular epithelial was greatly decreased when fully developed pinopodes formed. The expression of the PR in the glandular epithelial cells was negatively correlated with the progesterone level in serum （r= -0. 550, P〈 0.01 ）and it was negatively correlated with pinopodes developmental stage（r=-0. 793,P〈0.01）. （4）Levels of estrogen receptors and serum estradiol did not correlate with pinopodes formation. Conclusions： Progesterone regulated the expression of pinopodes by PR. The formation of pinopodes was concurrent with serum progesterone increasing and down-regulation of glandular epithelial progesterone receptors.