细胞核增殖抗原ki-67在异位和在位子宫内膜中的表达

Expression of proliferation cell nuclear antigen ki-67 in ectopic endometrium and eutopic endometrium

目的:探讨细胞核增殖抗原ki-67在子宫内膜异位症中的表达和子宫内膜细胞增殖能力对子宫内膜异位症发病的影响。方法:应用免疫组化SP法检测58例子宫内膜异位症(EMS组)患者(包括36例卵巢子宫内膜异位症和22例子宫腺肌症)的异位内膜和在位内膜及15例子宫肌瘤患者子宫内膜(对照组)中ki-67的表达情况,以增殖指数为统计指标。结果:卵巢EMS和子宫腺肌症的在位和异位内膜ki-67的表达差异均无统计学意义;对照组子宫内膜和EMS组在位内膜的腺体和间质的ki-67表达在增生期均显著高于分泌期,EMS异位内膜增殖指数在增生期和分泌期差异无统计学意义(P>0.05);EMS异位内膜ki-67增殖指数在增殖期低于在位内膜,但在分泌期则显著高于在位内膜(P<0.01);EMS异位内膜腺体Ⅰ～Ⅱ期时的ki-67表达高于Ⅲ、Ⅳ期(P<0.05),但在位内膜的ki-67表达在不同临床分期中差异无统计学意义(P>0.05)。结论:ki-67增殖指数反映了子宫内膜细胞的增殖活性,EMS异位内膜细胞持续增殖活跃可能在子宫内膜异位症发生、发展中起重要作用。

Objective： To explore the expression of proliferation cell nuclear antigen ki - 67 in endometriosis and the effect of pro- liferative activity of endometrial cells on the occurrence of endometriosis. Methods ： Immunohistochemical SP method was used to detect the expression levels of ki -67 in ectopic endometrium and eutopic endometrium of 58 cases with endometriosis （endometriosis group, including 36 cases with ovarian endometriosis and 22 cases with adenomyosis ） and normal endometrium of 15 cases with hysteromyoma （ control group） . Proliferation index （PI） was counted as statistical index. Results： There was no significant difference in the expression level of ki -67 in ectopic endometrium and eutopic endometrium between ovarian endometriosis group and adenomyosis group ; in control group and en- dometriosis group, the expression levels of ki - 67 in gland and mesenchyma of eutopic endometrium at proliferative phase were significantly higher than those at secretory phase; in endometriosis group, there was no significant difference in PI of ki - 67 in ectopic endometrium be- tween proliferative phase and secretory phase （P 〉 O. 05 ） . In endometriosis group, at proliferative phase, PI of ki - 67 in ectopic endome- trium was lower than that in eutopic endometrium ; but at secretory phase, PI of ki - 67 in ectopic endometrium was significantly higher than that in eutopic endometrium （P 〈 0.01 ） . In endometriosis group, the expression level of ki - 67 in gland of ectopic endometrium of stage I - lI was significantly higher than that in gland of ectopic endometrium of stage m and stage 1V （ P 〈 0. 05 ）, but there was no significant difference in the expression level of ki - 67 in eutopic endometrium of different clinical stages （ P 〉 0. 05 ） . Conclusion ： PI of ki - 67 re- flects the proliferative activity of endometrial cells, continuous proliferation and activation of ectopic endometrial cells in cases with endome- triosis may play an important role in the occurrence and development of endometriosis.