Survivin和MMP-9在子宫上皮和间质细胞中的表达与子宫内膜异位症间的关系

Expression of Survivin and MMP-9 in endometrium glandular epithelium and interstitial cells and its relationship with endometriosis

目的研究Survivin蛋白和基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)在子宫腺肌症(ade-nomyosis,AM)、腹壁子宫内膜异位症(abdominal wall endometriosis,AWEMS)、卵巢子宫内膜异位症(ovary endometri-osis,OEMS)的在位、异位内膜的腺上皮细胞和间质细胞中的表达,并与对照组进行比较,探讨其在子宫内膜异位症(endometriosis,EMS)的发生发展中的作用。方法采用免疫组化法检测各组织标本中Survivin和MMP-9的表达。结果 (1)在正常子宫内膜组织中Survivin、MMP-9均呈弱表达或无表达。在EMS三个病例组中,无论是在位内膜还是异位内膜组织Survivin、MMP-9的表达均有不同程度的上调,分别与正常子宫内膜组织表达比较差异有统计学意义(P<0.05)。(2)在AM、AWEMS、OEMS三个病例组中,仅在增生期异位内膜腺上皮细胞和间质细胞中Sur-vivin、MMP-9的表达分别高于在位内膜同类细胞的表达,差异均有统计学意义(P<0.05);分泌期则呈不规律表达。(3)在AM、AWEMS、OEMS三个病例组中,限定相同组织部位、相同细胞类型,增生期与分泌期Survivin、MMP-9的表达水平差异无统计学意义(P>0.05)且无周期性。(4)在AM、AWEMS、OEMS三个病例组中,限定相同生理期、相同组织部位比较腺上皮细胞与间质细胞Survivin、MMP-9的表达:腺上皮细胞显著高于间质细胞的表达,差异有统计学意义(P<0.05)。(5)EMS三个病例组之间,限定相同生理期、相同组织部位、相同细胞类型,组间分别比较Survivin或MMP-9的表达水平:Survivin表达差异无统计学意义(P>0.05),异位内膜仅分泌期MMP-9在AWEMS腺上皮细胞的表达(4.45±0.18)和AM腺上皮细胞的表达(4.68±0.17)高于OEMS异位内膜腺上皮细胞的表达(2.13±0.12),差异均有统计学意义(P<0.05)。结论 Survivin和MMP-9在EMS在位内膜和异位内膜腺上皮细胞和间质细胞中高表达可能是内异症发生发展的重要因素并有协同作用,在位内膜异常是EMS发病的决定性因素,腺上皮细胞高表达在EMS的发生发展中起主导作用,AM、AWEMS、OEMS三个病例组中的生物学特性不同可能受发病诱因、腹腔内环境及多种相关因子影响。

Objective To study the expression and effect of Survivin and MMP-9 in glandular epithelium and interstitial cells of eutopic and ectopic endomembrane of solenoma,abdominal ectopic and aberrant ovary,and its relationships with endometriosis.Method The expression of Survivin and MMP-9 in each sample were dectected by immunohistochemical method.Result （1） In normal endometrium,both Survivin and MMP-9 showed weak expression or no expression.In the three EMS groups, the expressions of Survivin and MMP-9 were up in varying degrees respectively,in either eutopic or ectopic endometrium,with significant differences compared to normal endometrium tissue（P0.05）.（2） In AM,AWEMS and OEMS groups,higher expression of Survivin and MMP-9 only in the proliferative phase of ectopic membrane epithelial cells with statistically significant differences compared to that in the same cells of eutopic endometrium（P0.05）;the expression in secretion phase was irregular.（3） In AM,AWEMS and OEMS groups, the expression levels of Survivin and MMP-9 in proliferative and secretory phases in tissue with same area and cell type were not significantly different（P0.05） and not periodic.（4） In AM,AWEMS and OEMS groups,by defining the same physical phase and tissues,the expression of Survivin and MMP-9 were much higher in glandular epithelium cells than in interstitial cells,with statistically significant differences（P0.05）.（5） In the three EMS groups,upon defining the same physical phase,tissues and cell type,the Survivin expression showed no significant differences between groups（P0.05）;the expression of MMP-9 in ectopic endometrial cell during secretion phase was higher in AWEMS epithelial（4.45±0.18） and AM epithelial cells（4.68±0.17） than that in the OEMS ectopic endometrial glandular epithelial cells（2.13±0.12）,and the differences were statistically significant（P0.05）.Conclusion The high expression of Survivin and MMP-9 in ectopic endomembrane and eutopic endomembrane of glandular epithelium cells and interstitial cells may be an important factor in the development of endometriosis.The latter plays more important role.The different biological characteristics between the three groups may be resulted from the cause of disease,intra-abdominal environmen and many other factors.