uPA及uPAR对子宫内膜异位症发生发展及临床分期的作用研究

Study on the roles of uPA and uPAR in occurrence,development and clinical stages of endometriosis

目的：研究尿激酶型纤溶酶原激活物（uPA）及尿激酶型纤溶酶原激活物受体（uPAR）对子宫内膜异位症（简称内异症）发生发展的作用。方法：应用免疫组化方法检测uPA、uPAR蛋白在内异症组（40例）异位内膜、在位内膜中及在对照组（30例）子宫内膜中的表达。结果：①异位内膜、在位内膜、对照组子宫内膜的腺上皮细胞及间质细胞均表达uPA及uPAR蛋白，主要定位于细胞浆；②uPA蛋白在异位内膜表达间质细胞高于腺上皮细胞（P〈0．05），uPA蛋白在间质细胞表达异位内膜高于在位内膜及对照组内膜（P〈0．05）；③uPAR蛋白在异位内膜及对照组内膜表达腺上皮细胞高于间质细胞（P〈0．05），uPAR蛋白在腺上皮细胞表达异位内膜高于在位内膜及对照组内膜（P〈0．05）；④uPA及uPAR蛋白在Ⅰ-Ⅱ期、Ⅲ～Ⅳ期异位内膜表达均高于对照组内膜（P〈0．05）；⑤异位内膜间质细胞uPA与异位内膜腺上皮细胞uPAR表达呈正相关（P〈0．05）；⑥uPA及uPAR蛋白在血管内皮呈阳性表达。结论：异位内膜间质细胞uPA蛋白高表达及异位内膜腺上皮细胞uPAR蛋白高表达可能共同促使异位内膜转移、粘附、侵袭、生长，对内异症的发生发展起重要作用。uPA及uPAR对内异症发生发展及临床分期的作用研究对内异症的临床治疗有-定的指导意义。

Objective： To research the roles of uPA and uPAR in occurrence and development of endometriosis. Methods： Immu- nohistochemical method was used to detect the expressions of uPA protein and uPAR protein in 40 cases of ectopic endometrium, 40 cases of eutopic endometrium, and 30 cases of normal endometrium. Results： uPA protein and uPAR protein expressed in stromal cells and glandular epithelial ceils of ectopic, eutopic, and normal endometrium, which mainly located in cytoplasm. The level of uPA protein in stromal cells of ectopie endometrium was statistically significantly higher than that in glandular epithelial cells of ectopic endometrium （ P 〈 0. 05 ） . The level of uPA protein in stromal cells of ectopic endometrium was statistically significantly higher than those of eutopic endometrium and normal endometrium （ P 〈 0. 05 ） ; the level of uPAR protein in glandular epithelial cells of ectopic endometrium and normal endometrium were statistically significantly higher than those in stromal cells （ P 〈 0. 05 ）, the level of uPAR protein in glandular epithelial cells of eetopic endometrium was statistically significantly higher than those of eutopic endometrium and normal endometrium （ P 〈 0. 05 ） ; the levels of uPA protein and uPAR protein in ectopie endometrium of stages I - II, III - IV were statistically significantly higher than those in normal endo- metrium （ P 〈 0. 05 ） ; there was a positive correlation between uPA protein in stromal cells of ectopic endometrium and uPAR protein in glan- dular epithelial cells of ectopic endometrium （ P 〈 0.05 ） ; uPA protein and uPAR protein were positive in vascular endothelial cells. Conclusion： High expressions of uPA protein in stromal cells of ectopie endometrium and uPAR protein in glandular epithelial cells of ectopic endometrium may promote metastasis, adhesion, invasion, and growth of eetopic endometrium, which play important roles in growth and development of endometriosis, uPA and uPAR has a certain guiding significance for clinical treatment of endometriosis.