MMP-2、MMP-9及TIMP-1在多囊卵巢综合征病人种植窗口期内膜的表达及其临床意义

Expression of MMP-2、MMP-9 and TIMP-1 in endometrium of PCOS patients during the implantation window phase and its clinical significance

目的:检测基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶-2(MMP-2)及组织金属蛋白酶抑制物-1(TIMP-1)在多囊卵巢综合征(PCOS)病人种植窗口期子宫内膜组织中的表达情况,并探讨其临床意义。方法:选择接受促排卵后治疗的PCOS病人(PCOS组)12例和因男方因素不孕且月经正常前来就诊病人(对照组)15例,检测2组排卵后第7天子宫内膜组织中MMP-9、MMP-2和TIMP-1蛋白表达情况,利用病理图像分析技术,对实验结果进行半定量分析。结果:MMP-9、MMP-2和TIMP-1在2组子宫内膜组织中均呈阳性表达,在间质细胞和腺上皮细胞的细胞质内均有棕黄色颗粒物沉着,以腺上皮表达为主。PCOS组子宫内膜腺上皮MMP-2、MMP-9及TIMP-1表达均明显低于对照组(P<0.01),子宫内膜间质MMP-9表达亦低于对照组(P<0.05)。结论:MMP-9、MMP-2和TIMP-1在PCOS组病人的种植窗口期子宫内膜中的表达水平较低,这可能是导致PCOS病人采用促排卵治疗后妊娠率低、流产率高的原因之一。

Objective:To investigate the expression of matrix metalloproteinase(MMP)-9,MMP-2 and matrix metalloproteinase inhibitor-1(TIMP-1)in endometrium of polycystic ovary syndrome(PCOS)patients during the implantation window phase,and to explore its significance.Methods:A total of 12 patients with PCOS who received post ovulation induction treatment(PCOS group)and 15 patients with infertility due to male factors and normal menstruation(control group)were selected.The expressions of MMP-9,MMP-2 and TIMP-1 proteins in endometrial tissue of the two groups on the seventh day after ovulation were detected.The pathology image analysis technology was employed to conduct the semi-quantitative analysis.Results:The expressions of MMP-9,MMP-2 and TIMP-1 in the two groups in endometrium were positive,and the brown granule cell pigmentation was found in the glandular epithelial cells and stromal cells cytoplasm,especially in the former ones.The expressions of MMP-2,MMP-9 and TIMP-1 in endometrial glandular epithelium in PCOS group were significantly lower than those in control group(P<0.01),and the expression of MMP-9 in endometrial stroma was also lower than that in control group(P<0.05).Conclusions:The low expression of MMP-9,MMP-2 and TIMP-1 in the implantation window phase of endometrium may be one of the causes of low pregnancy and high abortion rate in PCOS patients undergoing ovulation induction treatment.