无排卵型功血患者子宫内膜VEGF和雌、孕激素受体的表达

Expression of VEGF, Estrogen and Progesterone receptor in the endometrium of patients with anovulatory dysfunctional uterine bleeding

研究无排卵型功血患者子宫内膜血管内皮生长因子 (VEGF)、雌激素受体 (ER)和孕激素受体 (PR)的表达 ,探讨其与子宫内膜血管形成的关系 ,以求从蛋白水平阐明无排卵型功血的出血机制。采用免疫组化方法 ,检测VEGF、ER和PR在 2 0例正常增殖期和 6 0例无排卵型功血患者子宫内膜的表达。选用微血管密度标记物CD34,测定子宫内膜微血管密度 (MVD)。无排卵型功血患者单纯性增生和复合性增生子宫内膜腺上皮VEGF蛋白和MVD明显低于正常增殖期 (P <0 0 5和P <0 0 1 ) ;而单纯性增生和复合性增生子宫内膜腺上皮PR蛋白明显高于正常增殖期 (P <0 0 5和P <0 0 1 )。相关分析显示 ,子宫内膜腺上皮VEGF与MVD呈显著性正相关 (r =0 6 6 6 ,P <0 0 5 ) ;与腺上皮PR呈显著性负相关 (r=- 0 6 2 9,P <0 0 5 )。正常增殖期内膜与功血增殖期内膜比较 ,腺上皮VEGF和PR蛋白差异无显著性意义。首次指出病理表现为单纯性增生和复合性增生的无排卵型功血患者 ,其子宫异常出血与子宫内膜VEGF和PR的表达失调有关。PR间接作用于无排卵型功血子宫内膜腺上皮VEGF ,使后者分泌减少 ,微血管形成障碍 。

To investigate the expression of vascular endothelial growth factor (VEGF), estrogen receptor (ER), and progesterone receptor (PR) in the endometrium of patients with anovulatory dysfunctional uterine bleeding(DUB) To analyze the correlation between VEGF, steroid receptors and angiogenesis in the endometrium, and then try to demonstrate the mechanisms of abnormal bleeding in the patients of anovulatory DUB Immunohistochemistry was used to study the expression of VEGF, ER and PR in patients including twenty cases of normal proliferative phase and forty cases of anovulatory DUB CD34,a marker of microvessel, was selected to measure microvessel density (MVD) in endometrium VEGF immunoreactivity in glandular epithelial cells were significantly lower in the endometrium of simple and complex hyperplasia in comparison to the proliferative endometrium ( P <0 05 & P <0 01) However, glandular PR immunoreactivity was significantly higher in the simple and complex hyperplastic endometrium compared with proliferative endometrium( P <0 05 & P <0 01) Glandular VEGF positively correlated with MVD (r = 0 666 P <0 05)and negatively with glandular PR in the endometrium(r =-0 629 P <0 05) There was no significant difference between the normal proliferative and anovulatory DUB endometrium in terms of VEGF and PR protein level Our results demonstrated the charateristic of simple and complex hyperplastic endometrium which came from anovulatory DUB patients, and that the abnormal uterine bleeding is associated with disregulation of VEGF and PR in the endometrium PR proteins inter the expression of glandular VEGF in the anovulatory DUB endometrium by some indirect mechanism, and the decreased secretion of VEGF will result in the disruption of angiogenesis, and lead to the irregular uterine bleeding