绝经前后子宫内膜息肉中肥大细胞类胰蛋白酶及类糜蛋白酶的表达及意义

Expressions and their significance of mast cell tryptase and mast cell chymase in premenopausal and postmenopausal endometrial polyps

目的探讨肥大细胞类胰蛋白酶(MCT)及类糜蛋白酶(MCC)在绝经前、后子宫内膜息肉组织(EP)中的表达及临床意义。方法收集120例患者标本,其中绝经前EP组和绝经后EP组各35例,绝经前正常增生期子宫内膜组和绝经后正常萎缩性子宫内膜组各25例。采用Max VisionTM/HRP免疫组织化学染色法,检测各组中MCT及MCC阳性的肥大细胞(MCs)数量并分析临床意义。结果绝经前、后EP组和正常子宫内膜组中MCT和MCC阳性的MCs计数均值分别为高倍镜下(11.82±5.24)个和(2.94±2.20)个、(4.18±2.32)个和(2.18±1.52)个、(2.19±1.80)个和(0.49±0.60)个以及(0.35±0.32)个和(0.19±0.26)个。两两比较结果显示,绝经前、后EP组MCT和MCC阳性的MCs数量明显高于同期正常子宫内膜组(P<0.05);在EP组中,MCT阳性的MCs数量在绝经前高于绝经后(P<0.05),而MCC阳性的MCs数量没有明显差异(P>0.05);在正常子宫内膜组中,MCT和MCC阳性的MCs数量在绝经前均高于绝经后(P<0.05)。结论肥大细胞(MCs)的过度活化以及伴随的炎症性损害可能是绝经前、后子宫内膜息肉形成及发展的原因。

Objective To evaluate the expressions and their significance of mast cell tryptase（ MCT） and mast cell chymase（ MCC） in endometrial polyps（ EPs） of premenopausal and postmenopausal women. Methods The tissue specimens collected from 120 patients were divided into 4 groups： premenopausal EP group（ n = 35）,postmenopausal EP group（ n = 35）,normal proliferative endometrium group（ n = 25） and normal atrophic endometrium group（ n = 25）. The number of MCT and MCC positive mast cells（ MCs） were detected by Max VisionTM/HRP immunohistochemistrymethod.Results The number of MCT and MCC positive MCs in EP group and normal endometrium group of premenopausal and postmenopausal phase were（ 11. 82 ± 5. 24）/high power（ HP） and（ 2. 94 ± 2. 20）/HP,（ 4. 18 ± 2. 32）/HP and（ 2. 18± 1. 52）/HP,（ 2. 19 ± 1. 80）/HP and（ 0. 49 ± 0. 60）/HP,（ 0. 35 ± 0. 32）/HP and（ 0. 19 ± 0. 26）/HP,respectively. Compared with normal endometrium group in the same period,the number of MCT and MCC positive MCs in either premenopausal EP group or postmenopausal EP group were significantly higher（ P 〈 0. 05）. In EP group,the number of MCT positive MCs in premenopausal women were higher than that in postmenopausal women（ P 〈 0. 05）.There was no significant difference on the number of MCC positive MCs between pre-and postmenopausal women（ P 〉0. 05）. In endometrial group,the number of MCT and MCC positive MCs in premenopausal women were higher than that in postmenopausal women（ P 〈 0. 05）. Conclusion Overactivity of MCs in endometrum, resulting in endometrial inflammatory lesions,may be an inducement of EPs formation and development in endometrium.