p53、p21、MDM2蛋白在卵巢子宫内膜异位症病人血清、异位及在位内膜组织中的表达及相关性

Expression and correlation of p53,p21 and MDM2 proteins in serum,ectopia and in endometriosis patients

目的探讨p53、p21、MDM2蛋白在卵巢子宫内膜异位症病人血清、异位及在位内膜组织中的表达及相关性。方法采用随机数字表法选取2012年1月至2017年3月在郑州人民医院收治的卵巢子宫内膜异位症病人手术切除的异位内膜组织50例作为异位组、子宫内膜异位症病人自愿刮宫术取得的在位子宫内膜组织40例作为在位组,刮宫术取得非子宫内膜异位症病人的正常子宫内膜组织35例作为对照组,异位组及在位组病人(共90例,为观察组)。使用免疫组化染色法(S-P法)对p53、p21、MDM2蛋白的表达情况进行检测。结果异位组p53、p21表达阳性率(12.00%、10.00%)明显低于对照组(37.14%、31.43%)及在位组(35.00%、30.00%),P<0.05;异位组MDM2表达阳性率(52.00%)明显高于对照组(5.71%)及在位组(7.50%),P<0.05;在位组与对照组比较(35.00%、30.00%、7.50%比37.14%、31.43%、5.71%),p53、p21、MDM2表达阳性率差异无统计学意义(P>0.05);对照组、在位组分泌期p53、p21表达(66.67%、60.00%;61.11%、61.11%)均明显高于组内增生期(15.00%、10.00%;13.64%、13.64%),P<0.05,对照组、在位组、异位组分泌期MDM2表达阳性率(6.67%、11.11%、47.83%)与组内增生期(5.00%、4.55%、55.56%)比较,均差异无统计学意义(P>0.05);子宫内膜异位症病人的异位子宫内膜组织中p53表达与p21表达呈正相关(r=0.721,P<0.01);p53表达与MDM2表达呈负相关(r=-0.421,P<0.01);p21表达与MDM2表达无相关性(r=0.308,P>0.05)。观察组血清p53、p21水平[(0.86±0.23)kU/L、(1.04±0.12)kU/L]明显低于对照组[(1.38±0.19)kU/L、(1.68±0.24)kU/L],MDM2水平[(2.19±0.33)kU/L]明显高于对照组[(1.03±0.15)kU/L],P<0.05。结论 p53、p21、MDM2蛋白表达在子宫内膜异位症的发生发展中起着重要作用,且它们之间有一定的相关性。

Objective:To investigate the expression and correlation of p53,p21 and MDM2 proteins in serum,ectopic and eutopic endometrium of patients with ovarian endometriosis.Methods 50 cases of ectopic endometrial tissues surgically removed from patients with ovarian endometriosis treated in Zhengzhou People’s Hospital from January 2012 to March 2017 were selected as the ectopic group,40 cases of in situ endometrial tissue obtained from patients with endometriosis by voluntary curettage were treated as the in situ group,and 35 cases of normal endometrial tissue obtained from patients without endometriosis by curettage were treated as the control group by random number table method.The tissue samples were analyzed,all the tissue specimens were confirmed by pathology.Immunohistochemical staining(S-P)was used to detect the expression of p53,p21 and MDM2 proteins,to analyze the expression and correlation of endometriosis in ectopic endometrium and eutopic endometrium in patients with ovarian endometriosis.Serum p53,p21 and MDM2 protein levels were detected in both the ectopic group and the in situ group(90 cases in total,the observation group)before surgery,and were compared with those in the control group.Results The positive rates of p53 and p21 in the ectopic group(12.00%,10.00%)were significantly lower than those in the control group(37.14%,31.43%)and the situ group(35.00%,30.00%),P<0.05.The positive rate of MDM2 expression in ectopic group(52.00%)was higher than that in control group(5.71%)and in situ group(7.50%),P<0.05.The situ group was compared with the control group(35.00%,30.00%M 7.50%vs.37.14%,31.43%,5.71%).The positive rates of p53,p21 and MDM2 were not statistically significant(P>0.05).The expressions of p53 and p21 in the secretory phase of the control group(66.67%,60.00%)and the situ group(61.11%,61.11%)were significantly higher than those in the proliferative phase of the group(15.00%,10.00%;13.64%,13.64%),P<0.05.The positive rate of secretory phase MDM2 in the control group and the situ group and the ectopic group(6.67%,11.11%,47.83%)was compared with that in the proliferative phase(5.00%,4.55%,55.56%).The differenc-es were not statistically significant(P>0.05).In patients with endometriosis,the expression of p53 in ectopic endometrial tissue was positively correlated with that of p21(r=0.721,P<0.01).The expression of p53 was negatively correlated with the expression of MDM2(r=-0.421,P<0.01).There was no correlation between the expression of p21 and the expression of MDM2(r=0.308,P>0.05).The serum levels of p53 and p21 in the observation group[(0.86±0.23)kU/L,(1.04±0.12)kU/L]were significantly lower than those in the control group[(1.38±0.19)kU/L,(1.68±0.24)kU/L]The level of MDM2 was significantly higher than that of the control group[(2.19±0.33)kU/L vs.(1.03±0.15)kU/L],P<0.05.Conclusion The expression of p53,p21 and MDM2 proteins is important in the pathogenesis and development of endometriosis,and there is a certain correlation between them.