M2型巨噬细胞在子宫内膜异位症中的表达及其与MVD的关系

Expression of M2-polarized macrophages in endometriosis and its relationship with MVD

目的:检测子宫内膜异位症(Endometriosis,EMs)组织中CD68、CD163的阳性表达并分析其与微血管生成的关系,探讨M2型巨噬细胞在EMs发病机制中的作用。方法:用CD68标记巨噬细胞(CD68+),用CD163标记M2型巨噬细胞(CD163+)和CD34标记微血管密度(microvessel density,MVD)。采用免疫组织化学Envision二步法检测EMs组35例异位内膜和20例EMs在位内膜以及20例正常对照组子宫内膜组织中的CD68、CD163的表达及MVD值。结果:EMs组的异位内膜及在位内膜组织中CD68、CD163、MVD的表达强度显著高于对照组(P<0.01);盆腔EMs I-II期与III-IV期比较无显著差异(P>0.05);各组月经周期中分泌期与增生期表达无显著差异(P>0.05)。EMs组异位内膜MVD与CD68+、CD163+巨噬细胞呈正相关(r=0.754,P<0.01;r=0.808,P<0.01)。结论:M2型巨噬细胞具有促血管生成作用,从而参与EMs的发生发展,阻断局部微环境中巨噬细胞向M2型分化,有望成为EMs治疗的新途径。

Objective： To detect the positive expressions of CD68 and CD163 in endometriosis, analyze their relationships with microvessel density （ MVD）, explore the effect of M2 - polarized macrophages in pathogenesis of endometriosis. Methods： CD68 was used to mark macrophages, CD163 was used to mark M2 -polarized macrophages, and CD34 was used to mark MVD. Immunohistochemical method （Envision） was used to detect the expression levels of CD68 and CD163, MVD values in 35 specimens of ectopic endometrium in endometri-osis group, 20 specimens of eutopic endometrium in endometriosis group, and 20 specimens of normal endometrium in controlgroup. Results： The expression levels of CD68 and CD163, MVD values in ectopic endometrimn and eutopic endometrium in endometriosis group were significantly higher than those in control group （P 〈 0. 01 ） ; there was significant difference between pelvic endometriotic lesions of stage Ⅰ - Ⅱ and pelvic endometriotic lesions of stage Ⅲ- Ⅳ （ P 〉 0.05 ） ; in the three groups, there was no significant difference in the expression levels of CD68 and CD163, MVD values between secretory phase and proliferative phase （P 〉 0.05） . In ectopic endometrium of endometriosis group, there was a positive correlation between MVD and CD68 ＋ macrophages and CD163 ＋ macrophages （T = 0. 754, P 〈 0. 01 ; T = 0. 808, P 〈 0. 01 ） . Conclusion： M2 - polarized macrophages can promote angiogenesis, participate in the occurrence and development of endometriosis, block the differentiation of macrophages to M2 - polarized maerophages in local microenvironment, which is expected to be one of the new ways for treatment of endometriosis.