甾体激素受体辅激活子-2对子宫内膜异位症患者孕酮抵抗的作用研究

Study on effect of steroid receptor coactivator-2 on progesterone resistance in patients with endometriosis

目的 通过检测子宫内膜异位症（endometriosis,EMs）患者异位内膜和正常子宫内膜中孕酮受体（progesterone receptor,PR）和甾体激素受体辅激活子-2（steroid receptor coactivator-2,SRC-2）的表达,探讨SRC-2对EMs患者孕酮抵抗的作用.方法 随机选取2013年6月～ 2014年5月间在山东省交通医院妇产科行腹腔镜或开腹手术的EMs患者45例（异位内膜组）和35例因子宫肌瘤行子宫切除术患者非瘤区对照子宫内膜组织（对照内膜组）.采用反转录PCR（reverse transcription-PCR,RT-PCR）和免疫组化检测异位内膜组和对照内膜组中PR和SRC-2的表达,并进行比较.结果 PR和SRC-2在异位内膜组中的表达显著低于对照内膜组（P＜0.05）;对照内膜组中PR和SRC-2的表达在增生期增强,并随着分泌期逐渐减弱,在整个月经周期中存在周期性变化,有统计学差异（P＜0.05）;异位内膜组中PR和SRC-2的表达在增殖期和分泌期比较,无周期性变化,差异无统计学意义.结论 SRC-2可以调控PR基因的转录反应,促进靶基因的转录和蛋白表达,其表达下降可导致子宫内膜PR的表达改变,从而显著消减子宫PR对孕酮的反应性.

Objective To investigate effect of SRC-2 on progesterone resistance by detecting the expression of progesterone receptor and steroid receptor coactivator-2 in ectopic endometrium of patients with endometriosis and normal endometrium in control group. Methods 45 cases of endometriosis patients admitted in department of obstetrics and gynecology of traffic hospital from June 2013 to May 2014 were selected as endometriosis group,and 35 cases ocontrol endometrial tissues in non-tumour region in patients with uterine fibroids who had a hysterectomy as control endometrium group. The expression of PR and SRC-2 in endometriosis and control group were detected by reverse transcription-PCR and immunohistochemistry. Results Expression of PR and SRC-2 in endometfiosis group were significantly lower than control groups （P 〈 0. 05 ） ;expression of PR and SRC-2 were enhanced in the proliferative phase and gradually weakened along with the secretory phase, existed cychcal variation in menstrual cycle,the difference had statistically significant （P 〈 0.05 ） ;expression of PR and SRC-2 had no periodic variation in the proliferative and secretory phase, the difference had no statistically significant. Conclusion SRC-2 could regulate transcription reaction of PR genes to promote transcription and protein expression of a target gene, its decreasing expression may lead to the changes of expression in the endometrium PR, PR significantly reduction of uterine progesterone reactivity.