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目的观察多囊卵巢综合征(PCOS)与无排卵性功能失调性子宫出血(DUB)患者子宫内膜血管紧张素Ⅱ(AngⅡ)及其2型受体(AT2)分布的差异。方法选择10例PCOS患者作为PCOS组,9例无排卵性DUB患者为DUB组,于黄体酮撤血后1个月左右分别行诊刮术。用免疫组织化学SABC法对各组子宫内膜AngⅡ及AT2表达进行细胞组分定位,计算机图像信号采集与分析系统测量子宫内膜腺上皮细胞、基质细胞、螺旋动脉管周基质细胞的灰度值(灰度值越高,表达越低)。结果PCOS组子宫内膜腺上皮AT2灰度值高于DUB组(158.3±13.6 vs 147.9±11.4,P<0.05),其余各染色指标在两组患者中差异无统计学意义。结论DUB患者腺上皮AT2明显高于PCOS患者,不利于子宫内膜的修复,可能与功血发病有关;PCOS患者腺上皮AT2较DUB低,腺上皮更易于增生,可能与子宫内膜癌发病有关。
Objective To observe the difference of endometrial angiotensin Ⅱ (Ang Ⅱ) and its type 2 receptor (AT2) in patients with polycystic ovary syndrome (PCOS) and anovulatory dysfunctional uterine bleeding (DUB). Methods Ten patients with PCOS were selected as the PCOS group and nine patients with anovulatory DUB as the DUB group. The patients were treated with curettage one month after the withdrawal of progesterone. Immunohistochemical SABC method was used to locate the cellular components of the endometrial Ang Ⅱ and AT2 in each group. The gray value of endometrial glandular epithelial cells, stromal cells and pericytes peritumoral stromal cells were measured by computer image signal acquisition and analysis system (The higher the gray value, the lower the expression). Results The gray value of AT2 in PCOS group was higher than that in DUB group (158.3 ± 13.6 vs 147.9 ± 11.4, P <0.05). There was no significant difference in the other staining indexes between the two groups. Conclusions The AT2 in gland epithelium of DUB patients is significantly higher than that of PCOS patients and is not conducive to the repair of endometrium, which may be related to the pathogenesis of dysfunctional uterine bleeding. AT2 in glandular epithelium of PCOS patients is lower than that of DUB, and the glandular epithelium is more likely to proliferate, which may be related to the pathogenesis of endometrial cancer .