子宫内膜异位症局部雌激素代谢酶的表达及意义

Local Expression and Significance of Steroid Metabolizing Enzymes in Endometriosis

目的:研究子宫内膜异位症的异位内膜雌激素产生、代谢与在位内膜及正常内膜存在的差异及其意义。方法:采用RT-PCR及免疫组化方法检测67例卵巢子宫内膜异位囊肿患者的异位子宫内膜、在位内膜组织P450芳香化酶(P450A)mRNA及蛋白质、17β羟基类固醇脱氢酶Ⅱ(17β-HSDⅡ)mRNA的表达,并与35例对照组正常子宫内膜比较。结果:①35例正常子宫内膜不表达P450AmRNA,但自增生晚期始有17β-HSDⅡmRNA的微量表达,分泌期逐渐增高并于分泌晚期达到高峰;②患者在位内膜可有P450AmRNA微弱表达;而17β-HSDⅡmRNA表达趋势与正常子宫内膜一致,但强度低于正常内膜;③67例卵巢异位内膜均有P450AmRNA的表达,但缺乏17β-HSDⅡmRNA表达。结论:子宫内膜异位症患者的异位内膜能够自合成雌激素,但局部雌激素代谢缺陷,其导致持续的雌激素微环境是异位内膜生长的主要因素。

Objective：To investigate the estrogen metabolism in matched ectopic and eutopic tissue from patients with endometriosis and in normal endometrium.Methods：P450 aromatase（P450A） mRNA and protein、17β-Hydroxysteroid dehydrogenase 2（17β-HSDⅡ） mRNA expression in eutopic and ectopic endometrium of patients with endometriosis（n= 67） and in normal endometrium from control group（n=35） were detected by reverse transcription-polymerase chain reaction and immunohistochemistry.Results：①P450AmRNA was not expressed in control group,but 17β-HSDⅡ mRNA was detected weakly at late proliferative phase and gradually increased to peak in the late secretory phase.② P450AmRNA and protein were weakly expressed in eutopic tissue of endometriosis,while the expression of 17β-HSDⅡ mRNA in eutopic tissue was similar to that of control group,except its intensity was lower than that of normal control.③ All ectopic tissue in 67 cases of endometriosis presented P450AmRNA and protein expression,but the expression of 17β-HSDⅡ mRNA was absent.Conclusions：The ectopic endometrium of endometriosis can produce estrogen by itself,but the metabolism is defecit,so the local consistant estrogen concentration might be the reason of growth of ectopic endometrium.