雌激素受体-α在子宫腺肌病子宫内膜肌层交界区中的表达

Expression of ERα in endometrial-myometria interface of human adenomyosis

目的 分析雌激素受体（ER）-α在子宫腺肌病（ADS）内膜肌层交界区（EMI）子宫肌层中的表达情况及相关性.方法 收集北京妇产医院2009年5月至11月行全子宫切除术的子宫标本共41例,分为ADS组20例和子宫肌瘤组（对照组）21例,结合组织解剖和免疫组化定位并获取EMI肌层,对其EMI平滑肌细胞进行分离及原代培养;分别应用RT-PCR和Western印迹方法 ,检测Erα在两组EMI肌层组织中的表达.结果 （1）EMI平滑肌细胞于培养后48～72 h即贴壁生长,细胞群呈长梭形、束状或栅栏状排列,细胞生存力良好;（2）Erα在ADS组EMI肌层中的表达无明显周期性变化,在对照组EMI肌层中的表达存在周期性变化,其中在子宫内膜的增生期高于分泌期（P〈0.05）;（3）Erα在增生期ADS组（0.180±0.023）与对照组（0.190±0.024）的表达差异无统计学意义,在分泌期ADS组（0.17±0.032）的表达高于对照组（0.12±0.015）,但差异无统计学意义（P〉0.05）.结论 Erα在ADS子宫的EMI中失去周期性表达,与ADS的雌激素调节异常有关.

Objective To examine and analyze the expression of estrogen receptor-or （ERct） in myometrium of endometrial-myometria interface （EMI） of adenomyosis and normal myometrium and explore the pathogenesis of adenomyosis （ADS）. Methods The myometrium specimens were obtained from 41 cases undergoing hysterectomy, including 20 adenomyosis patients in ADS group and 21 other patients in control group. EMI was located and acquired by anatomy and immunohistochemistry. The EMI smooth muscle cells were isolated immediately post-operatively for primary culture. RT-PCR and Western blot were used to detect ERct in myometrium of EMI in two groups. Results （ 1 ） Uterine smooth muscle cells of EMI were in an excellent condition and cell viability was fair; （2） the expression of ERtx in myometrium of EMI of ADS group showed no cyclic change. While in myometrium of EMI in control group, it showed obvious cyclic change. The expression level was significantly higher in proliferative stage than that in secretory stage （ P 〈 0. 05） ; （3） there was no significant difference in the expression of ERα between the ADS （0. 18±0. 023） and control groups （0. 19± 0. 024） during the proliferative phase. During the secretory phase, it showed significant difference in ERa expression. And the ADS group （ 0. 17 ±0. 032 ） was much higher than the control group （ 0. 12± 0. 015 ） （ P 〉 0. 05 ）. Conclusion The loss of periodic expression of ERα in myometrium of EMI of adenomyosis may be associated with an abnormal regulation of estrogen in adenomyosis.