米非司酮对腹壁切口子宫内膜异位病灶CD16、CD32、CD64的影响及意义

The expression and clinical significance of CD16、CD32 and CD64 at the ectopic foci of endometriosis in abdominal incision after mifepristone treatment

目的探讨术前服用不同剂量和时间的米非司酮(RU486)对术后腹壁切口子宫内膜异位症(AIEM)异位病灶CD16、CD32、CD64的影响及意义。方法将40例AIEM患者分为:对照组(未服RU486,10例),服药组:A组(服用RU48612.5mg/d×1月,10例),B组(服用RU486 12.5mg/d×3月,10例),C组(服用RU486 25mg/d×1月,10例),采用免疫组化检测AIEM术后异位病灶CD16、CD32、CD64的表达。结果 1CD16、CD32、CD64在AIEM异位病灶的表达水平,对照组明显低于各服药组(P<0.001)。2服药组间CD16、CD32、CD64在AIEM异位病灶的表达与RU486服用剂量呈正相关(P<0.001)。3服药组间CD16、CD32、CD64在AIEM异位病灶的表达与服药时呈正相关(P<0.001)。4CD16、CD32、CD64在AIEM异位病灶表达,服药1个月组与服药3个月组间比较有统计学意义(P<0.001)。5CD16、CD32、CD64在AIEM异位病灶表达,服药12.5 mg/d组与25 mg/d组间无统计学意义(P>0.05)。结论 1 RU486上调AIEM异位病灶CD16、CD32、CD64表达,提示CD16、CD32、CD64阳性细胞水平的变化在RU486治疗女性AIEM患者的免疫机制中可能起一定作用。2AIEM异位病灶CD16、CD32、CD64的表达水平随着RU486的日服用量和服用时间的增加而增加。

Objective To investigate the expression and clinical significance of CD16 , CD32 and CD64 at the ectopic loci of endometriosis in abdominal incision after treatment with mifepristone in different doses and duration. Methods Forty cases of patients were involved in this study. Among the forty, 10 cases of untreated patients were set as control group, the others were set as experimental group and equally subdivided into three groups, the patients in group A were treated with mifeprisitone 12.5mg/d for 30days, patients in group B were treated with mifeprisitone 12.5mg/d for 90days and patients in group C were treated with mifeprisitone 25mg/d for 30days. CD16, CD32 and CD64 at the ectopic endometrium of endometriosis in abdominal incision were examined by the methods of immunohistochemistry after the lesions were resected. Results 1 ） Among the four groups, the expression of CD16, CD32 and CD64 at the ectopic foci in the control group of endometriosis in abdominal incision were significantly lower than those in the other three experiment groups （P 〈 0. 001, respectively）. 2） In the experiment group ,the expression of CD16 ,CD32 and CD64 at the ectopic foci were positively correlated with the dosage of mifeprisitone （CD16 r =0. 574, P 〈0.001 ）, CD32 r = 0. 921, P 〈 0. 001 ）, and （ CD64 r = 0.849, P 〈 0. 001 ）. 3 ）In the experiment group, the expression of CD16 ,CD32 and CD64 at the ectopic foci were positively correlated with the medication time of mifeprisitone （ CD16 r = 0. 818, P 〈 0. 001 ） ; （ CD32 r = 0. 568, P 〈 0. 001 ） ; and（CD64 r = 0. 430, P 〈 0. 001 ）. 4） The expression of CD16,CD32 and CD64 at the ectopic fociwere significantly different between the 30 -day and 90 -day treatment （P 〈0.001 respectively）. 5 ）No significant difference of the expression of CD16, CD32 and CD64 at the ectopie loci was observed between the two groups who were treated with mifeprisitone 12.5mg/d and 25mg/d respectively（P 〉0.05）. Conclusion 1 ）The immunocompetent cells expressed CD16, CD32 and CD64 at the eetopic loci of endometriosis in abdominal incision were significantly increased with the medication time of mifeprisitone. It is suggested that the cells expressed CD16 ,CD32 and CD64 at the eetopie loci may play a certain role in the preopertative therapy of endometriosis in abdominal incision. 2）The expression of CD16,CD32 and CD64 at the eetopie foei were as increased with the dosage and the medication time of mifeprisitone.