子宫腺肌病中同源框基因10和整合素β3的表达与不孕的关系

The relationship of expression of HOXA10 and intergin β3 in infertile women with adenomyosis

目的：观察同源框基因10（HOXA10）及整合素β3（Intβ3）在子宫腺肌病（AM）患者在位内膜、子宫内膜-肌层交界面以及异位病灶中的表达情况,探讨子宫腺肌病不孕原因。方法：以2014年2~8月在本院住院因子宫腺肌病行子宫全切术者31例为观察组,其中增殖期内膜15例,分泌期内膜16例;因宫颈上皮内瘤变Ⅲ级（CINⅢ级）或宫颈肌瘤行子宫全切术者33例为对照组,其中增殖期内膜15例,分泌期内膜18例。通过免疫组化链霉菌抗生物素蛋白-过氧化物酶连接（SP）法,测定并分析子宫腺肌病患者在位内膜、内膜-肌层交界面以及异位病灶中HOXA10与Intβ3的表达情况,并用双盲法评分进行分析比较。结果：1无论在增殖期还是分泌期,观察组结合带HOXA10和Intβ3的表达均低于对照组（P〈0.05）。2增殖期HOXA10观察组异位内膜表达弱于对照组正常内膜,而与在位内膜未发现有差异（P〉0.05）;Intβ3表达强度由高到低依次为对照组正常内膜、观察组异位内膜、观察组在位内膜（P〈0.05）。3观察组在位内膜和对照组正常内膜增殖期HOXA10及Intβ3的表达均低于各自分泌期（P〈0.05）。4观察组在位内膜增殖期和分泌期HOXA10及Intβ3的表达分别低于同期对照组正常内膜（P〈0.05）。结论：子宫腺肌病患者在位子宫内膜、结合带Intβ3及HOXA10的表达下降,异位病灶处Intβ3表达增强,分泌期该两种因子均低表达,可能是导致不孕的重要原因之一。

Objective： To investigate the expression of homeobox gene 10 （HOXA10） and integrin β3（Intβ3）in eutopic endometrium, endometrium near myometrium, or endometrial ectopic lesions of infertile women with adenomyosis, and to explore the reason of infertility. Method From Feb. 2014 to July 2014, 31 infertile women with adenomyosis who came to Affiliated Hospital of Inner Mongolia Medical University for hysterectomy were in experimental group, which included 15 women with proliferative endometrium, 16 women with secretory endometrium. And another 33 women who had experienced hysterectomy because of cervical intraepithelial neoplasia III （CIN III） or cervical fibroids were in control group, which included 15 women with proliferative endometrium, 18 women with secretory endometri- urn. The expression of HOXA10 and Intβ3 in tissue of eutopic endometrium, endometrium near myometrium, or endo- metrial ectopic lesions of the uterine specimens of all the women were checked by immunohistochemistry streptavidin biotin peroxidase. Result..1.The expression of HOXA10 and Intβ3 in endometrium near myometrium both in prolifera- tive and secretory endometrium of women in experimental group had significant higher than those of women in control group（P〈0.05）. 2. The expression of HOXA10 of endometrial ectopic lesions in proliferative endometrium of women in experimental group had significant lower than that of women in control group, but in eutopic endometrium, there was no significant difference between the two groups （P 〉0.05）. As for expression intensity of Intβ3, it was most strong in eutopic endometrium of women in controll group, more strong in endometrial ectopic lesions of women in ex- perimental group, and strong in eutopic endometrium of women in experimental group, which difference had statistical significance （P〈0.05）. 3.The expression of HOXA10 and Intβ3 in eutopic proliferative endometrium both in the two groups had significant higher than those in secretory endometrium （P〈0.05）.4. The expression of HOXA10 and Intβ3 in eutopic proliferative and secretory endometrium of women in experimental group had significant lower than those o~ women in control group （P%0.05）. Conclusion： The expressions of HOXA10 and Intβ3 decrease in eutopic endometri um and endometrium near myometrium, the expression of Intβ3 endometrialis increases in endometrial ectopic lesions, and the expressions of HOXA10 and Intβ3 decrease for secretory endometrium may be one of the important reason for infertility of women.