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目的探讨细胞外基质金属蛋白酶诱导因子(extracellular matrix metalloproteinase inducer,EMMPRIN)、基质金属蛋白酶2(matrix metalloproteinases2,MMP-2)、基质金属蛋白酶9(MMP-9)和血管内皮生长因子(vascular endothelial growth factor,VEGF)在子宫内膜异位症(endometriosis,EM)中的表达及意义。方法应用免疫组化SABC三步法检测57例EM患者子宫内膜组织(57例异位内膜,51例在位内膜)和同期48例非EM患者的正常子宫内膜(对照组)中EMMPRIN、MMP-2、MMP-9及VEGF的表达情况,并对各蛋白表达水平进行相关性分析。结果 EMMPRIN、MMP-2、MMP-9及VEGF在EM异位内膜表达[分别为(0.723±0.114)、(0.729±0.109)、(0.692±0.089)、(0.704±0.103)]均高于EM在位内膜组[分别为(0.396±0.097)、(0.365±0.023)、(0.349±0.030)、(0.370±0.129)](P<0.05);Pearson相关分析显示,在EM异位内膜中各蛋白表达呈显著正相关(P<0.05)。在EM异位内膜组中EMMPRIN、MMP-2、MMP-9及VEGF表达Ⅲ～Ⅳ期[分别为(0.780±0.058)、(0.779±0.064)、(0.736±0.050)、(0.749±0.059)]高于Ⅰ～Ⅱ期[分别为(0.563±0.070)、(0.588±0.079)、(0.570±0.051)、(0.580±0.100)](P<0.05)。MMP-2在EM在位内膜组表达较对照组高(P<0.05)。结论 EMMPRIN、MMPs和VEGF在EM中高表达,EMMPRIN-MMPs-VEGF系统上调可能在EM异位内膜种植、侵袭中发挥重要作用。
Objective To investigate the expression of extracellular matrix metalloproteinase inducer (EMMPRIN), matrix metalloproteinases 2 (MMP-2), matrix metalloproteinase 9 (MMP-9) and vascular endothelial growth factor , VEGF) in endometriosis (EM) and its significance. Methods The normal endometrium of 57 patients with ectopic endometrium (57 ectopic endometrium, 51 eutopic endometrium) and 48 non-EM patients (control group) were detected by immunohistochemical SABC three-step method. EMMPRIN, MMP-2, MMP-9 and VEGF expression, and the correlation analysis of the protein expression levels. Results The expressions of EMMPRIN, MMP-2, MMP-9 and VEGF in EM ectopic endometrium were significantly higher than those in EM (0.723 ± 0.114, 0.729 ± 0.109, 0.692 ± 0.089, (0.396 ± 0.097), (0.365 ± 0.023), (0.349 ± 0.030) and (0.370 ± 0.129), respectively (P <0.05). The Pearson correlation analysis showed that in eutopic endometrium The protein expression was positively correlated (P <0.05). The expressions of EMMPRIN, MMP-2, MMP-9 and VEGF in stage Ⅲ-Ⅳ of EM ectopic endometrium were 0.780 ± 0.058, 0.777 ± 0.050, 0.749 ± 0.059, (0.563 ± 0.070), (0.588 ± 0.079), (0.570 ± 0.051) and (0.580 ± 0.100), respectively (P <0.05). The expression of MMP-2 in EM eutopic endometrium group was higher than that in control group (P <0.05). Conclusion EMMPRIN, MMPs and VEGF are highly expressed in EM. Upregulation of EMMPRIN-MMPs-VEGF may play an important role in EM ectopic endometrial implantation and invasion.