盆腔器官脱垂患者子宫骶韧带COX2、PGE2和p16的表达及意义

Expression and significance of COX2,PGE2,and p16 in the uterosacral ligaments of patients with pelvic organ prolapse

目的探讨盆腔器官脱垂(POP)患者子宫骶韧带环氧化酶2(COX2)、前列腺素E2(PGE2)、p16的表达及其与年龄和胶原代谢的关系。方法应用免疫组化法检测POP组(POP患者)和对照组(非脱垂者)子宫骶韧带石蜡标本中COX2、PGE2、p16、Ⅰ型胶原蛋白(COLⅠ)和Ⅲ型胶原蛋白(COLⅢ)的表达;再将2组按照年龄分为<55岁亚组与>65岁亚组,并比较其表达情况;分析COX2、PGE2与COLⅠ和COLⅢ之间的相关性。结果POP组子宫骶韧带组织中COLⅠ和COLⅢ的表达水平低于对照组,COX2、PGE2表达则高于对照组;POP组与对照组的<55岁亚组与>65岁亚组COX2、PGE2表达水平无明显差异;COX2、PGE2与COLⅠ和COLⅢ的表达呈负相关;2组p16表达无明显差异,但在>65岁亚组中的表达高于<55岁亚组。结论COX2、PGE2在POP患者子宫骶韧带组织中表达水平升高,从而使韧带组织胶原纤维的含量减少。COX2、PGE2的表达水平与年龄无明显关系。COX2/PGE2信号通路可能参与POP的发生发展。

Objective To investigate the expression of COX2,PGE2,p16,COLⅠ,and COLⅢin uterosacral ligaments,with or without pelvic organ prolapse(POP)in patients of different ages.We have analyzed correlations between COX2,PGE2,COL I,and COLⅢexpression,and discuss their significance and the relationships between COX2,PGE2,p16,and collagen metabolism.Methods We have assessed expression levels of COX2,PGE2,p16,COL I,and COLⅢin uterosacral ligament paraffin specimens of POP patients and non-POP control patients by immunohistochemistry.Results Expression levels of COL I and COLⅢwere higher in the control group.Levels of COX2 and PGE2 were higher in the POP group,but showed no significant differences between patient cohorts younger than 55 years and older than 65 years.Expression of PGE2 positively correlated with that of COX2,both of which correlated negatively with the expression of COL I and COLⅢ.No significant difference between groups was observed in p16 expression,though it trended higher in>65-yearold patients of both groups than in<55-year-old.Conclusion Expression levels of COX2 and PGE2 are higher in uterosacral ligaments of patients with POP,leading to reduction in collagen expression in ligaments.The COX2/PGE2 pathway may be involved in the occurrence and development of POP,especially among younger patients.