Ki-67、bcl-2、Survivin和Cyclin D1在子宫内膜息肉及其周围内膜的表达及其意义

THE EXPRESSION OF Ki -67,bcl -2,Survivin AND Cyclin Dl IN THE POLYPS REGION AND ITS ADJACENT ENDOMETRIUM OF PATIENTS WITH ENDOMETRIAL POLYPS

目的探讨增殖/凋亡失衡在子宫内膜息肉(endometri alpolyps,EP)发病中的作用。方法采用免疫组织化学SP法检测了35例EP及其周围组织和32例正常子宫内膜组织(对照组)中Ki-67、bcl-2、Survivin和Cyclin D1的表达,并对各指标在月经周期不同时期的表达进行分析。结果①35例EP中22例取自增殖期,全部(22/22,100%)表现为增殖状态;13例取自分泌期者,76.9%(10/13)呈现增殖状态,只有15.4%(2/13)表现为分泌状态,7.7%(1/13)介于增殖期与分泌期之间。②在增殖期亚组,EP与息肉周围内膜的腺体中Ki-67、bcl-2、Survivin及Cyclin D1的表达均明显高于对照组(P<0.05);而EP与息肉周围内膜的腺体中Ki-67、bcl-2、Survivin及Cyclin D1的表达差异无统计学意义(P>0.05)。在分泌期亚组,EP与息肉周围内膜的腺体中Ki-67、Survivin的表达均明显高于对照组(P<0.05);但bcl-2和Cyclin D1的表达差异无统计学意义(P>0.05)。结论大部分EP持续表现为增殖状态,仅少数存在分泌期转化。Ki-67、bcl-2、Survivin及Cyclin D1在EP及其周围内膜的腺体中的表达增高说明增殖亢进和凋亡障碍在EP的发病中发挥作用,而且这种改变并不仅仅存在于息肉局部。

Objective To detect the expression of Ki -67,bcl -2,Survivin and Cyclin D1 in endometrial polyps （ ED）, adjacent endometrium and normal endometrium in reproductive - age women in the aspect of proliferation and apoptosis in order to acquire the clues of EP pathogenesis. Methods All the patients were chosen from the Second Hospital of Hebei Medical University and Dingzhou People＇s Hospital during October 2007 to December 2008. The expression of Ki - 67, bcl - 2, Survivin and Cyclin D1 was detected in ED, adjacent endometrium and normal endometrium in 35 EP women and 32 controls by immunohistochemistry. Results Among the 35 cases of EP, all of the cases that were acquired in proliferative phase were all in proliferative state （22/22,100%） ,76.9% of the cases that were acquired in secretory phase were in proliferative state,and only 15.4% was in secretory state （2/13） and 1 case was between the two different kinds of states （7.7%）. In proliferative phase group, the expression of Ki -67 bcl- 2, Survivin and Cyclin Dlin the gland of EP and adjacent endometrium was significantly stronger than that in control group （ P 〈 0.05 ）. The expression of Ki - 67, bcl - 2, Survivin and Cyclin Dlin the gland of ED and adjacent endometrium showed no significant difference （ P 〉 0. 05 ）. In secretory phase group, the expression of Ki -67 and Survivin in the gland of EP and adjacent endometrium was significantly stronger than that in control group （P 〈 0.05 ）. In secretory phase group, the expression of Cyclin D1 and bcl -2 in gland and stroma of the three parts showed no significant difference （ P 〉 0.05）. Conclusion Most of the EP are in proliferative state and not in phase changing following the corresponding endometrium of menstrual cycle. EP and adjacent endometrium are all in hyperproliferative and apoptosis - inhibited state. The pathological changes of EP can include polyps itself and its adjacent endometrium, it is not restricted to local part of endometrial polyps.