子宫内膜异位症在位内膜Bcl-2的表达及其意义

A study of Bcl-2 expression in eutopic endometrium from women with endometriosis

目的检测子宫内膜异位症在位子宫内膜Bcl- 2的表达 ,探讨其在子宫内膜异位症发生机制中的作用。方法采用免疫组织化学法 (SP法 )对 45例盆腔子宫内膜异位症和 44例壁间型子宫肌瘤患者在位子宫内膜进行Bcl- 2表达检测。结果 (1)对照组Bcl- 2主要表达于子宫内膜腺上皮细胞胞浆和 /或胞膜。增生期Bcl- 2表达显著高于分泌期 (P <0 0 0 1)。 (2 )子宫内膜异位症组Bcl- 2亦主要表达于子宫内膜腺上皮细胞胞浆和 /或胞膜。增生期Bcl- 2表达显著高于分泌期 (P <0 0 5 )。(3)子宫内膜异位症组与对照组比较 ,其分泌期Bcl- 2表达显著高于对照组 (P <0 0 0 2 )。结论子宫内膜周期性生理变化与Bcl- 2的表达水平改变有关。子宫内膜异位症在位子宫内膜分泌期抗凋亡能力明显增强。推测这种具有抗凋亡活性的子宫内膜细胞逆流至盆腹腔后 ,因其高水平Bcl- 2表达 ,得以逃避机体免疫清除系统的影响而在异位存活、种植。为子宫内膜异位症的发生创造了先决条件。

Objective To evaluate the function of Bcl-2 in the etiology or pathogenesis of endometriosis. Methods Immunohistochemistry method (streptavidin-peroxidase method) was used to detect the expression of Bcl-2 protein in eutopic endometrium from patients with endometriosis (45 cases) and intramural myoma of uterus (44 cases). Results 1. The control group: the expression of Bcl-2 predominated in the glandular cytoplasm and /or on the plasma membrane. Bcl-2 expression in proliferative phase was higher than that in secretory phase significantly ( P <0.001). 2. The endometriosis group: Bcl-2 expression also predominated in the glandular cytoplasm and/or on the plasma membrane. Bcl-2 expression in proliferative phase was higher than that in secretory phase ( P <0.05). 3. In endometriosis group that Bcl-2 expression in secretory phase was higher significantly than the control group ( P <0.002). Conclusions The cyclic changes of eutopic endometrium were related to Bcl-2 expression. The patients with endometriosis have a significant enhancement in their anti-apoptotic activity in secretory phase endometrium. It is suggested that the retrograding of these active anti-apoptotic endometrial cells may play a key role in the pathogenesis of endometriosis.