子宫内膜异位症患者内膜组织中TLR4及MyD88的表达

Expressions of TLR4 and MyD88 in eutopic and ectopic endometrium from patients with endometriosis

目的:探讨Toll样受体4(TLR4)介导的髓样分化因子88(MyD88)通路在正常子宫内膜、子宫内膜异位症(EMs)患者在位内膜及异位内膜组织中的表达及其临床意义。方法:选取EMs患者(EMs组)45例(Ⅰ、Ⅱ期15例,Ⅲ、Ⅳ期30例),取其异位内膜组织45例(异位内膜组)、在位内膜组织30例(在位内膜组),另取同期因子宫纵隔行宫腔镜手术患者的正常内膜组织30例(对照组)。采用半定量RT-PCR及免疫组化SP法检测TLR4及MyD88 mRNA和蛋白在上述组织中的表达情况。结果:异位内膜组、在位内膜组及对照组TLR4与MyD88 mRNA和蛋白的表达水平比较,差异有统计学意义(FmRNA=37.541、38.669,F蛋白=46.707、31.046,P均<0.001),且异位内膜组和在位内膜组均高于对照组,异位内膜组高于在位内膜组(P均<0.01)。EMsⅠ、Ⅱ期和Ⅲ、Ⅳ期患者异位内膜组织中TLR4与MyD88 mRNA及蛋白的表达水平比较,差异均无统计学意义(tmRNA=1.373、1.574,t蛋白=0.299、0.066,P均>0.05)。在位内膜组中TLR4与MyD88 mRNA及蛋白的表达均呈正相关(r分别为0.594和0.560,P均<0.001),异位内膜组中TLR4与MyD88 mRNA及蛋白的表达均呈正相关(r分别为0.812和0.639,P均<0.001)。结论:TLR4及MyD88的高表达可能在EMs的发病机制中起着重要作用。

Aim： To investigate the expressions and clinical significance of the Toll-like receptor 4 （ TLR4） mediated pathway via myeloid differentiation factor 88 （ MyD88） in eutopic and ectopic endometrium of endometriosis（ EMs） . Meth-ods： A total of 45 cases of EMs were selected（ EMs group,15 cases atⅠ and Ⅱstage,30 cases at Ⅲ and Ⅳ stage） ,and 45 cases of ectopic endometrium （ ectopic endometrium group） ,and 30 cases of eutopic endometrium （ eutopic endometri-um group） were obtained. During the same period,30 patients with septate uterus undergoing hysteroscopic surgery were selected as control group and their uterine endometrium was obtained. The expressions of TLR4 and MyD88 in the above groups were evaluated by semi-quantitative RT-PCR and immunohistochemical technique （ SP） . Results： The expressions of TLR4 and MyD88 mRNA and protein in ectopic endometrium group,eutopic endometrium group,and control group were statisti-cally significant （ F mRNA = 37. 541,38. 669,F protein = 46. 707,31. 046,P 0. 001） . Those in ectopic endometrium group and eutop-ic endometrium group were significantly higher than those in control group（ P 0. 01） ,and those in ectopic endometrium group were significantly higher than those in eutopic endometrium group（ P 0. 01） . No significant difference of the expressions of TLR4 and MyD88 mRNA and protein were found between early stage and advanced stage of EMs（ t mRNA = 1. 373,1. 574,t protein = 0. 299,0. 066,P 0. 05） . Correlation was found between the mRNA and protein expression levels of TLR4 and MyD88 in both ec-topic endometrium group（ r = 0. 594 and 0. 560,P 0. 001） and eutopic endometrium group （ r = 0. 812 and 0. 639,P 0. 001） . Conclusion： The high expressions of TLR4 and MyD88 may play an important role in the pathogenesis of EMs.