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目的:观察子宫腺肌病患者子宫在位及异位内膜组织CD146的表达与其微血管形成的关系,探讨子宫腺肌病患者微血管生成的变化。方法:手术切除子宫患者66例,其中子宫腺肌病40例(AM组),对照组26例。用免疫组织化学方法检测正常子宫内膜、腺肌病患者在位及异位内膜组织中CD146的表达及微血管数目和密度(MVD)值。结果:AM组在位内膜中MVD分泌期(33.7±4.9)明显高于增殖期(27.2±5.0)(P<0.01),对照组子宫内膜中MVD分泌期(20.5±3.8)与增生期(17.9±3.6)比较差异无统计学意义(P>0.05)。AM组与对照组相比无论是增殖期、分泌期及整个月经周期,在位内膜MVD均明显高于对照组内膜(P<0.01)。AM组患者在位内膜(4.1±1.4)与异位内膜(4.9±1.4)CD146表达评分比较差异有统计学意义(P<0.05),与在位内膜增殖期CD146表达评分(3.6±1.7)相比差异显著,与分泌期(4.7±0.6)相比评分增加,但差异无统计学意义(P>0.05);而与对照组内膜整个月经周期(2.4±0.8)及增殖期(2.4±0.7)、分泌期(2.3±0.9)相比CD146表达评分均明显增加,CD146在AM患者在位内膜85%(34/40)、异位内膜90%(36/40)及对照组内膜62%(16/26)的表达阳性率与对照组相比差异有统计学意义(P<0.01)。CD146与MVD具有明显的正相关性(r=0.567,P<0.01)。结论:腺肌病患者子宫内膜和异位内膜CD146表达显著增强,提示CD146在子宫内膜异位症微血管形成过程中发挥了重要作用。
Objective: To observe the relationship between CD146 expression and angiogenesis in uterus and ectopic endometrium of patients with adenomyosis and to explore the changes of angiogenesis in patients with adenomyosis. Methods: 66 cases of surgical resection of the uterus, including adenomyosis in 40 cases (AM group), control group of 26 cases. The expression of CD146 in eutopic and ectopic endometrial tissues and the number and density of microvessels in normal endometrium and adenomyosis were detected by immunohistochemistry. Results: The MVD secretion in the eutopic endometrium of AM group was significantly higher than that in the proliferative phase (33.7 ± 4.9) (27.2 ± 5.0) (P <0.01), while the secretion of MVD in the control group was (20.5 ± 3.8) (17.9 ± 3.6), there was no significant difference (P> 0.05). Compared with the control group, the MVD in eutopic endometrium in AM group was significantly higher than that in control group (P <0.01), both in proliferative phase, secretory phase and menstrual cycle. There were significant differences in CD146 expression score between eutopic endometrium (4.1 ± 1.4) and ectopic endometrium (4.9 ± 1.4) in AM group (P <0.05) 1.7) compared with the control group (4.7 ± 0.6), but the difference was not statistically significant (P> 0.05); while compared with the control group, the total menstrual cycle (2.4 ± 0.8) and the proliferative phase 2.4 ± 0.7) and secretory phase (2.3 ± 0.9) compared with the expression of CD146, CD146 in eutopic endometrium of 85% (34/40), ectopic endometrium of 90% (36/40) and control The positive rate of 62% (16/26) expression in the endometrium was significantly different from that in the control group (P <0.01). There was a significant positive correlation between CD146 and MVD (r = 0.567, P <0.01). Conclusion: The expression of CD146 in endometriosis and ectopic endometrium in patients with adenomyosis is significantly increased, suggesting that CD146 plays an important role in the microvascular formation of endometriosis.