子宫腺肌病EMI处MMP-7和E-Cadherin的表达及意义

The expression and clinical significance of matrix metalloproteinase-7 and E-cadherin in uterine adenomyosis lesions and its endometrial-myometrial interface

目的:检测基质金属蛋白酶-7(MMP-7)及上皮钙黏素-E(E-cadherin)在子宫腺肌病病灶与内膜-肌层界面(EMI)处在位内膜的表达情况,了解MMP-7及E-cadherin在子宫腺肌病发病中的作用.方法:选取因子宫腺肌病行全子宫切除或次全子宫切除的子宫标本40例,同时以子宫良性病变(如子宫肌瘤)行全子宫切除或次全子宫切除的子宫标本30例作为对照.采用免疫组化方法检测MMP-7及E-cadherin在子宫腺肌病病灶、子宫内膜-肌层界面处组织中的表达水平,测定这两种蛋白分子表达的阳性单位(PU值).结果:在子宫腺肌病组中病灶和内膜-肌层交界处内膜MMP-7较对照组表达水平上调;E-cadherin的表达下调;两者在子宫腺肌病子宫内膜-肌层交界处的内膜表达水平呈负相关.结论:子宫EMI处子宫内膜腺体细胞MMP-7表达增高,降解了子宫肌层的细胞外基质,其屏障作用减弱,基底层子宫内膜细胞容易侵入子宫肌层生长并形成异位病灶;EMI处腺体细胞E-cadherin表达下调,直接导致细胞黏附能力下降,细胞解聚,子宫内膜细胞之间以及子宫内膜细胞与基质之间的黏附作用降低,从而变得易从在位部位解离,侵入和种植在肌层中.

Objective： To measure the expression of matrix metalloproteinase-7（ MMP-7） and E-cadherin in both adenomyotic lesions and eutopic endometrium of endometrial-myometrial interface（EMI）,and to illustrate the role of MMP-7 and E-cadherin in the development of adenomyosis.Methods： Uterus samples of 40 cases of adenomyosis and 30 cases of benign uterine diseases（ such asuterine fibroids）,who received total hysterectomy or subtotal hysterectomy,were collected from the Department of gynaecology in the First Affiliated Hospital of Jinan University. Expression of MMP-7 and E-cadher in both adenomyotic lesions and eutopic endometrium of EMI were detected using immunohistochemistry assay. Results： The MMP-7 immunoreactivity was significantly increased in adenomyosis ectopic foci and the eutopic endometrirm of EMI. On the contrary,the expression of Ecadherin was obviously decreased. The expression of MMP-7 and E-cadherin are negatively correlated.Conclusion： The increased expression of MMP-7 in endometrial gland cells of EMI degrades the extracellular matrix of myometrium and abate its barrier function. Thus,basal endometrial cells are easy to invade the myometrium and grow to form ectopic foci. The reduced expression of E-cadherin directly leads to the decrease of cell adhesion ability,which causes cell depolymerization,and lessens the adhesion between endometrial cells themselves and the adhesion between endometrial cells and matrix.Therefore,endometrirm cells become easier to dissociate from the eutopic endometrirm,intrude and implant into the musclar layer.