雌激素介导的上皮-间质转换在子宫内膜异位症中的作用

Role of estrogen-induced epithelial-mesenchymal transition in occurrence of endometriosis

目的:探讨雌激素介导的上皮-间质转换在子宫内膜异位症发生发展中的作用。方法:选择2009年1月～2012年1月在重庆市西郊医院进行手术治疗并诊断为子宫内膜异位症的50例患者作为实验组(EMS组),选择同期健康体检者40例作为对照组。应用免疫组织化学、Western blot方法检测在位子宫内膜以及异位内膜标本中上皮细胞的标志分子E-cadherin和基质细胞标志分子Vimentin的表达,同时检测血清中雌二醇水平。结果:异位内膜上皮细胞中E-cadherin表达阳性率为20.00%,在位内膜为38.00%,明显低于正常对照组(P<0.01)。异位内膜上皮细胞中Vimentin的表达阳性率为74.00%,在位内膜为54.00%,明显高于正常对照组(P<0.01)。Western blot结果表明,异位内膜组织中E-cadherin表达量明显低于正常内膜组织,而Vimentin明显高于正常内膜组织(P<0.001)。内异症患者分泌中期血清中雌二醇水平明显高于正常对照组(P<0.001)。结论:内异症患者异位内膜和在位内膜上皮细胞的标志分子E-cadherin表达降低,而基质细胞标志分子Vimentin表达上调,说明上皮-间质转换过程与子宫内膜异位症发生相关,而且雌激素可能参与了介导子宫内膜上皮细胞发生间质转换的过程。

Objective： To explore the role of estrogen - induced epithelial - mesenchymal transition （EMT） in occurrence and de- velopment of endometriosis. Methods： Fifty patients who underwent surgery and were diagnosed as endometriosis in the hospital from Janu- ary 2009 to January 2012 were selected as experimental group, 40 women who received health physical examination in the hospital during the same period were selected as control group. Immunohistochemical method and western blot were used to detect the expressions of E - cadher- in and Vimentin in epithelial cells of eutopic endometrium and ectopic endometrium, meanwhile, the levels of serum estradiol in the two groups were detected. Results： The positive expression rates of E - cadherin in ectopic ensometrium and eutopic endometrium were 20. 00% and 38. 00%, respectively, which were statistically significantly lower than that in control group （P 〈 0.01 ） . The positive expression rates of Vimentin in ectoplc ensometrium and eutopic endometrium were 74.00% and 54. 00%, respectively, which were statistically significantly higher than that in control group （P 〈 0. 01 ） . The results of Western blot showed that the expression rate of E - cadherin in ectopic ensome- trium was statistically significantly lower than that in normal endometrium, but the expression rate of Vimentin in ectopic ensometrium was statistically significantly higher than that in normal endometrium （P 〈 0. 001 ） . The level of serum estradiol during metaphase of secretory phase in patients with endometriosis was statistically significantly higher than that in control group （P 〈 0. 001 ） . Conclusion： Down - reg- ulation of E - cadherin and up - regulation of Vimentin in ectopic endometrium and eutopic endometrium of patients with endometriosis reveal that epithelial - mesenchymal transition is correlated with occurrence of endometriosis, and estrogen may participate in the course.