P2X7受体在卵巢子宫内膜异位症异位内膜组织中的表达

Expression of P2X7 receptor in endometriosis tissues of patients with ovarian endometriosis

目的观察嘌呤受体P2X7在正常子宫内膜和子宫内膜异位症（EMS）异位内膜组织中的表达，探讨其在EMS发生发展中的可能作用。方法收集2011年10月至2012年10月本院手术治疗的育龄期EMS患者（54例）卵巢异位内膜组织及子宫肌瘤全子宫切除术患者（40例）正常子宫内膜组织的石蜡标本，采用免疫组化技术测定两组患者内膜组织中P2X7受体的表达情况。根据EMS患者术前血清CAl25水平及术中采用修订的美国生育协会（rAFS）评分法评定的EMS分期的不同进行分组，比较各组EMS患者异位内膜P2X7表达强度的差异。结果（1）54例EMS患者异位内膜组织中P2X7受体阳性表达41例（其中弱阳性22例，阳性14例，强阳性5例），阳性表达率为75．9％，而40例子宫肌瘤患者正常子宫内膜组织中P2X7受体阳性表达仅3例（均为弱阳性），阳性表达率为7．5％，两组间P2X7受体阳性表达率及表达强度差异均有统计学意义（X^2=43．21；Z=-7．318，P〈0．05）。（2）术前血清CAl25≥50U／mL、rAFS法分期Ⅲ～Ⅳ期的EMS患者异位内膜P2X7受体表达强度高于CAl25〈50U／mL、rAFS法分期Ⅰ～Ⅱ期者，差异均有统计学意义（Z=-2．642，P〈0．05；Z=-3．815，P〈0．001）。结论P2X7受体在EMS患者异位内膜组织中呈高表达，且术前血清CAl25水平更高、病变更重者表达强度也更高，提示P2X7受体可能与EMS的发生发展相关。

Objective To investigate the different expressions of purinergic P2X7 receptor in normal endometrium and ectopie endometrium of patients with endometriosis （EMS）, so as to discuss the possible role of P2X7 receptor in the development of EMS. Methods The tissue samples （ovarian endometriotic cysts） of EMS patients （EMS group, n= 54） and normal endometrium tissues from uterine fibroid patients undergoing hysterectomy （control group, n= 40） from Oct. 2011 to Oct. 2012 were retrieved in Changhai Hospital. The expression of P2X7 receptor was detected and compared by immunohistoehemistry between the two groups. P2X7 receptor expressions were also compared between patients with different preoperative serum CA125 levels or EMS stage according to intraoperative evaluation by revised American Fertility Society （rAFS） staging. Results （1） The positive rate of P2X7 receptor was 75.9% （41/54, with 22 weakly positive, 14 positive and 5 strongly positive） in 54 EMS samples, which was significantly higher than that in normal endometrial tissues （7.5 %, 3/40, all weakly positive）（X^2 =43.21, P%0.05）. P2X7 receptor expression intensities were also significantly different between the two groups（Z=-7. 318, P〈0. 05）. （2） P2X7 receptor expressions in EMS patients with serum CA125 ≥50 U/mL or ofⅢ-Ⅳ stage （rAFS） were significantly stronger than those with serum CA125 〈 50 U/mL （ Z=-2. 642, P〈0. 05） or of Ⅰ -Ⅱ stage （Z=-3. 815,P〈0. 001）. Conclusion P2X7 receptor is highly expressed in the ectopic endometrium tissue, and the expression is associated with the pre-operation serum CA125 level and severity of disease, suggesting that P2X7 receptor may be involved in the development of endometriosis.