神经细胞黏附因子在子宫腺肌病病灶中的表达及意义

Expression and significance of neural cell adhesion molecule in adenomyosis

目的：：检测神经细胞黏附因子（ NCAM）在子宫腺肌病在位内膜及异位内膜中的表达,探讨NCAM在子宫腺肌病发病中的作用。方法：采用免疫组化法检测40例子宫腺肌病标本在位内膜与异位内膜组织中 NCAM 的表达情况（分泌期与增生期各20期）,并与20例正常子宫内膜标本进行比较。采用0~10级NRS疼痛评价量表对子宫腺肌病患者痛经程度进行评分,并与相应患者NCAM染色情况进行比较。结果：NCAM在40例子宫腺肌病在位内膜和异位内膜及19例正常内膜腺上皮中均有表达,1例正常内膜无表达,间质中无表达。异位内膜组织中NCAM表达明显高于在位内膜和正常对照组（ P〈0.01）。在位内膜组织分泌期NCAM表达含量高于增生期（ P〈0.05）。子宫腺肌病异位病灶NCAM表达与患者痛经程度呈正相关（r=0.84,P〈0.01）。结论：NCAM可能参与子宫腺肌病的发病过程,并参与子宫腺肌病痛经的发生发展,但具体分子机制尚需进一步研究。

Objective：To investigate the expression of neural cell adhesion molecule （ NCAM） in the eutopic endometrium and ectopic lesions from patients in adenomyosis and its possible role in the pethogenesis of adenomyosis. Methods：The expressions of NCAM in the eu-topic and ectopic samples of adenomyosis were assayed by immunohistochemical staining and the result was compared with the normal endometrial samples by H-score method. Result：NCAM was observed in the endometrial glandular epithelium of all the ectopic and ectopic sam-ples and 19 normal samples. No positive results were observed in stroma. The staining intensity of NCAM in ectopic lesion was significantly higher than that in the eutopic endometrium and normal endometrium （ P〈0 . 01 ） , whereas no statistical difference was observed in the expres-sion between the eutopic endometrium and normal endometrium of patients with adenomyosis. For eutopic endometrium of adenomyosis,expression was higher in the secretory phase than that in the proliferative phase（P〈0. 05）. The expression of NCAM in ectopic lesion of adenomyosis was positively correlated with the severity of dysmenorrhea （ r=0 . 84 , P〈0 . 01 ） . Conclusions：NCAM may participate in the occurrence and development of adenomyosis and may contributes to the occurrence and development of dymenorrhea,but the exact moleculor mechanisms still re-main to be discovered.