米非司酮作用下Bcl-2及Fas在子宫腺肌病异位病灶中的表达

The expression of Bcl-2 and Fas in the ectopic focus of adenomyosis under the action of mifepristone

目的探讨米非司酮作用下,子宫腺肌病患者肌层异位病灶中,细胞凋亡因子Bcl-2及Fas的表达变化。以及在增生期及分泌期,异位病灶中细胞凋亡因子Bcl-2及Fas是否呈周期性变化。方法 2003年1月-2009年1月在长春市中心医院妇产科,经临床确诊为子宫肌腺病,要求手术治疗的180例患者。将其随机分成两组,实验组给予米非司酮口服后手术治疗,应用免疫组化法检测肌层异位病灶中Bcl-2、Fas基因的表达变化。结果实验组和对照组中,增生期与分泌期相比较,Bcl-2及Fas均呈持续性表达且无周期性变化。而实验组与对照组相比较,增生期和分泌期,Bcl-2表达均明显下降,而Fas表达明显上升。结论 (1)米非司酮可以降低子宫腺肌病异位病灶中的细胞凋亡抑制因子Bcl-2的阳性表达率,同时提高细胞凋亡促进因子Fas的阳性表达率,从而导致异位病灶中的细胞凋亡增强。(2)子宫腺肌病异位病灶中,增生期与分泌期,Bcl-2基因和Fas基因的表达呈持续性且无周期性变化,可能导致病灶中的部分细胞免于凋亡,使细胞凋亡率明显下降,而成为子宫腺肌病的发病机制之一。

Objective The intention of this experiment is to discuss the expression-change of cellular apoptosis factors,Bal-2 and Fas,under the action of mifepristone in myometrium ectopic foucs of the patients of adenomyosis.We also discuss that the cellular apoptosis factors,Bcl-2 and Fas,show the periodical change in the proliferative stage and the progestational stage,whether or not.Methods The research object are 180 patients,who had been clinical definited as adenomyosis,inquiried operation treatment in the department of gynaecology and obstetrics in Changchun Center hospital from January 2003 to January 2009.All the patients are randomly divided into two groups,one is experimental group,the other one is control group.In the experimental group,all the patients are given mifepristone by mouth before the operations,then the expression of Bcl-2 and Fas genes in ectopic foucs is measured by immunohistochemical method.Results In the experiment group and the contral group,the proliferative stage contrast with the progestational stage,Bcl-2 and Fas are expressed persistently and have no periodical change.To compare the experiment group with the control group,Bcl-2 lowers obviously and Fas has increased obviously in the experimental group comparing with that in the control group.Conclusion（1）In the ectopic foucs of adenomyosis,mifepristone can decline the rate of the positive expression of Bcl-2,which is the cellular apoptosis inhibitive factor,and at the same time raise the rate of the positive expression of Fas,which is the cellular apoptosis enhancing factor.It can reduce the cellular apoptosis enhancement in the ectopic focus.（2）In the ectopic foucs of adenomyosis,it shows that the expression of Bcl-2 and Fas are persistently and have no obvious periodical change in the proliferative stage and progestational stage.It may be induce many cells which in the ectopic foucs to avert apoptosis and make the rate of cellular apoptosis to lower obviously.The weakening of cellular apoptosis of ectopic endometrium may be one of the etiopathogenesis of adenomyosis.