骨桥蛋白在子宫内膜异位症的表达及意义

Expression and significance of osteopontin in endometriosis

目的:检测子宫内膜异位症(EM)组织和血清中骨桥蛋白(OPN)的表达,探讨子宫内膜异位症的发病机制。方法:采用免疫组化方法检测OPN在研究组的异位内膜、在位内膜及对照组内膜的表达;分别应用ELISA与免疫荧光法测定两组术前及术后1周血清中OPN及CA125水平。此外,应用免疫组化法检测OPN在26例回顾性子宫内膜异位症患者异位内膜的表达。结果:①研究组异位内膜、在位内膜OPN表达均高于对照组内膜,异位内膜OPN的表达也高于同期在位内膜;②术前研究组血清OPN水平高于对照组(P<0.05);③研究组异位内膜OPN的表达及血清OPN水平与内异症的临床分期有关,而在位内膜OPN表达与临床分期无关;④回顾性资料复发的病例异位内膜组织中OPN表达强度明显高于未复发病例。结论:OPN与子宫内膜异位症发生、发展、病情的严重程度及复发、预后密切相关,提示OPN可作为判断内异症患者预后的指标之一;内异症患者血清OPN水平与异位内膜组织OPN表达一致,能反映异位内膜组织OPN的变化,且敏感性及准确性较CA125高,因此检测血清OPN可能成为内异症辅助诊断指标。

Objective：To detect the expressions of osteopontin（OPN） in the tissues of endometriosis and serum,explore the pathogenesis of endometriosis. Methods：Immunohistochemical method was used to detect the expressions of OPN in ectopic endometrium and eutopic endometrium of study group and the normal endometrium in control group;ELISA and immunofluorescence method were used to detect the levels of OPN and CA125 in serum in the two groups before treatment and one week after treatment,respectively.In addition,immunohistochemical method was used to detect the expression of OPN in ectopic endometrium of 26 cases with endometriosis. Results：The expression levels of OPN in ectopic endometrium and eutopic endometrium of study group were significantly higher than that in normal endometrium in control group,the expression level of OPN in ectopic endometrium of study group was significantly higher than that in eutopic endometrium of study group.Before treatment,the expression level of serum OPN in study group was significantly higher than that in control group（P0.05）.In study group,the expression levels of OPN in ectopic endometrium and serum were related to the clinical stages of endometriosis,but there was no correlation between OPN expression in eutopic endometrium and clinical stages.The expression level of OPN in ectopic endometrium of recurrent cases was significantly higher than that in ectopic endometrium of non-recurrent cases. Conclusion：OPN is related to the occurrence,development,severity,relapse and prognosis of endometriosis closely,which indicates that OPN can be used as an index to predict the prognosis of cases with endometriosis;the serum level of OPN in the patients with endometriosis identifys with the expression of OPN in ectopic endometrium,which can reflect the change of OPN in ectopic endometrium,and its sensitivity and accuracy are higher than those of CA125,thus,detection of serum OPN may be used as an assisted-diagnostic index for endometriosis.