FUT4和LeY在子宫内膜异位症中的表达及临床意义

Expression of fucosyltransferase 4 and Lewis Y in endometriosis and its clinical significance

目的 探讨FUT4和LeY在子宫内膜异位症患者中的表达情况及其临床价值。方法 选择2010年3月～2012年6月辽宁省大连市妇幼保健院（以下简称“我院”）妇产科经腹腔镜手术证实为子宫内膜异位症的70例患者,将患者分为在位内膜组和异位内膜组,每组各35例。同时选择同期我院行手术治疗的单纯子宫肌瘤患者35例为对照组。采用免疫组化、RT-PCR检测三组患者子宫内膜组织中FUT4和LeY的表达情况,并对其变化的意义进行评价和分析。结果 1与对照组比较,在位内膜组和异位内膜组患者的FUT4阳性表达率均明显提高,差异有统计学意义（P〈0.05）,异位内膜组FUT4的阳性表达率高于在位内膜组（P〈0.05）;2与对照组比较,在位内膜组和异位内膜组患者的LeY的阳性表达率均明显提高,差异有统计学意义（P〈0.05）,异位内膜组LeY的阳性表达率高于在位内膜组,差异有统计学意义（P〈0.05）;3与对照组比较,FUT4在异位内膜组和在位内膜组中的阳性表达率明显高于对照组,差异有统计学意义（P〈0.05）,异位内膜组FUT4的阳性表达率高于在位内膜组（P〈0.05）。结论 FUT4和LeY不仅在子宫内膜异位症的形成和发展过程中发挥着重要作用,其在胚胎黏附、植入过程中也起着重要作用,而FUT4是LeY合成的关键酶,当其表达量高于某一临界值时,会诱发子宫内膜异位症,影响胚胎的正常着床,从而进一步导致不孕。

Objective To explore the expression of LeY and FUT4 in patients with endometriosis and its clinical value. Methods 70 patients with endometriosis confirmed by laparoscopic surgery from March 2010 to June 2012 in Depart- ment of Gynecology and Obstetrics, Maternal and Child Health Hospital of Dalian City （“our hospital” for short）, and these patients were divided into eutopie endometrial group and ectopic endometrial group, with 35 patients in each group. 35 patients with uterine fibroids alone in our hospital during the same period were also selected as the control group. Immunohistochemistry and RT-PCR were used to detect the expression of FUT4 and LeY in endometrial tissues of three groups, the significance of their changes were evaluated and analyzed. Results ①Compared with the control group, the positive expression rate of FUT4 in eutopic endometrial group and eetopie endometrium group were signifi- cantly improved, and the difference was statistically significant （P 〈 0.05）, and the positive expression rate of FUT4 in ectopic endometrial group was higher than that in the eutopie endometrial group, the difference was statistically signifi- cant （P 〈 0.05）. ②Compared with the control group, positive expression rate of LeY in the eutopic endom etrial group and ectopie endometrium group were significantly improved, and the difference was statistically significant （P 〈 0.05）, positive expression rate of LeY in the eetopic endometrial group was higher than that in the eutopie endometrial group,the difference was statistically significant （P 〈 0.05）. ③Compared with the control group, positive expression rate of FUT4 in the ectopic endometrial group and eu-topic endometrial group was significantly higher, positive expression rate of FUT4 in the ectopic and the difference was statistically significant （P 〈 0.05）, while the endometrial group was higher than that in the eutopic endometrial group, the difference was statistically significant （P 〈 0.05）. Conclusion FUT4 and LeY not only plays an important role in the formation and development of endometriosis but also in embryonic adhesion and implantation process, espe- cially FUT4 is a key enzyme in the synthesis of LeY, while if a certain threshold is reached with its high expression, it will induce endometriosis, affecting the normal implantation of the embryo, which further leads to infertility.