子宫内膜异位灶电凝术后在位内膜着床因子LIF表达的变化

Expression change of LIF in endometrium after electrosurgery on endometriotic niduses

目的:通过观察腹腔镜下电凝子宫内膜异位病灶后在位内膜着床因子白血病抑制因子(LIF)表达的变化,了解电凝异位病灶对不孕症治疗的意义及其作用机制。方法:选择美国生殖学会(AFS)分期Ⅰ～Ⅱ期子宫内膜异位症的不孕患者50例作为研究对象,选择因男方因素经腹腔镜检查为正常盆腔的不孕妇女50名作为对照组。两组均行腹腔镜检查,发现异位灶尽量电凝去除。在行不孕腹腔镜检查前1个月经周期及术后第1、3个月经周期的第19～24天,取子宫内膜做LIF免疫组织化学及原位杂交检测,计算每份标本的染色强度,即子宫内膜LIF的含量。结果:子宫内膜LIFmRNA的表达:不孕合并子宫内膜异位症者术前为3.0±0.6,术后1个月4.1±0.9,3个月4.8±1.1,对照组则分别为5.9±1.2、6.1±1.1、6.3±1.0。研究组术前与术后比较差异有统计学意义,术前、术后与对照组比较差异均有统计学意义(P<0.05)。免疫组织化学检测子宫内膜LIF的变化:不孕合并子宫内膜异位症者术前为9.0±1.9,术后1个月11.6±2.4,3个月13.6±3.4,对照组分别为17.7±3.4、17.8±3.3、18.01±3.3。研究组术前与术后比较差异有统计学意义,术前、术后与对照组比较差异均有统计学意义(P<0.05)。结论:子宫内膜异位症患者在位内膜着床因子LIF表达有缺陷,腹腔镜下电凝异位病灶对其表达有一定改善,但无法恢复到正常人状态。

Objective： To understand the meaning and mechanism of electric coagulation on endometric niduses in treatment of infertility by observing the expression change of LIF in endometrium. Methods： Fifty cases of infertility women with endometriosis in AFS stage Ⅰ-Ⅱ were enrolled as study group, 50 cases of infertility women without endometriosis but with husband abnormal sperma were enrolled as control group. Both groups were performed laparoscopy, endometric niduses were removed by electric coagulation as completely as possible. Immunohistochemical localization of leukaemia inhibitory factor （LIF） protein and In-situ localization of leukaemia inhibitory factor （LIF） mRNA in endometrium were performed by medical image analytical system during 19-24 days of last one menstrual cycle before laparoscopy and the first and third menstrual cycle after laparoscopy. Results： The change of In-situ localization of LIF mRNA in endometrium ： the level of LIF mRNA were 3.0± 0.6 before laparoscopy, 4. 1 ± 0. 9 one month and 4. 8 ± 1.1 three month after laparoscopy in study group ; in control group, the level was 5.9 ± 1.2, 6. 1 ± 1.1, 6. 3 ± 1.0 separately. There was significant difference between two groups and significant change after laparoscopy in study group （P 〈 0. 05 ）. The change of immunohistochemical localization of LIF protein in endometrium： the level of LIF protein were 9.0 ± 1.6 before laparoscopy, 11.6 ±2.4 one month and 13.6±3.4 three month after laparoscopy in study group; in control group, the level was 17.7±3.4, 17.8±3.3, 18.0 ± 3.3 separately. There was significant difference between two groups and significant change after laparoscopy in study group （ P 〈 0.05 ）. Conclusion ： There was defectiveness in expression of LIF in endometrium of infertility women with endometriosis. There was some improvement in expression of LIF in endometrium after electric coagulation on endometric niduses, but could not recover to normal condition.