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目的:探讨症状性子宫肌瘤患者子宫内膜中tPA、PAI的表达。方法:子宫肌瘤患者子宫内膜标本70例,根据临床有无异常子宫出血的症状分为两组,A组(症状性子宫肌瘤)45例,其中增生期15例,分泌期13例,单纯增生过长10例,复杂增生过长7例;B组(无症状性子宫肌瘤)25例,其中增生期12例,分泌期13例。对照组分为C组和D组,C组:正常子宫内膜28例,其中增生期15例,分泌期13例;D组:功能失调性子宫出血30例,其中增生期11例,分泌期8例,单纯增生过长8例,复杂增生过长3例。采用免疫组化法检测各组子宫内膜中的tPA、PAI表达水平。结果:A组tPA的表达水平与B组和C组比较,均明显升高(P<0.001,P<0.001),但PAI水平明显降低(P<0.001,P<0.001);A组与D组子宫内膜tPA、PAI的表达比较,均无统计学差异(P>0.05);B组与C组子宫内膜tPA、PAI表达水平比较,均无统计学差异(P>0.05);D组与B组和C组比较,tPA表达水平升高,有统计学差异(P<0.001,P<0.001),而PAI水平降低(P<0.001,P<0.001)。结论:症状性子宫肌瘤患者子宫内膜中存在tPA、PAI的表达异常,且这种异常变化趋势与功能性子宫出血的内膜变化趋势一致。tPA、PAI的表达异常是临床上症状性子宫肌瘤患者发生异常子宫出血的原因。
Objective: To investigate the expression of tPA and PAI in endometrium of symptomatic uterine fibroids. Methods: 70 cases of uterine fibroids in patients with endometrial specimens, according to clinical symptoms of abnormal uterine bleeding were divided into two groups, A group (symptomatic uterine fibroids) 45 cases, of which 15 cases of proliferative phase, secretory phase in 13 cases, Simple hyperplasia in 10 cases, complex hyperplasia in 7 cases; B group (asymptomatic uterine fibroids) in 25 cases, including 12 cases of proliferative and secretory phase in 13 cases. The control group was divided into group C and group D, group C: 28 cases of normal endometrium, including 15 cases of proliferative phase and 13 cases of secretory phase. Group D: 30 cases of dysfunctional uterine bleeding, 11 cases of proliferative phase, 8 cases, simple hyperplasia in 8 cases, complex hyperplasia in 3 cases. Immunohistochemistry was used to detect the expression of tPA and PAI in the endometrium of each group. Results: The expression of tPA in group A was significantly higher than that in group B and group C (P <0.001, P <0.001), but the level of PAI was significantly lower (P <0.001, P <0.001) There was no significant difference in the expression of tPA and PAI between endometrium and endometrium (P> 0.05). There was no significant difference in the expression level of tPA and PAI between group B and group C (P> 0.05) The level of tPA in group B was significantly higher than that in group C (P <0.001, P <0.001), while PAI was lower (P <0.001, P <0.001). Conclusion: There is abnormal expression of tPA and PAI in the endometrium of patients with symptomatic uterine fibroids, and the tendency of this abnormal change is in line with the tendency of endometrial changes of functional uterine bleeding. Abnormal expression of tPA, PAI is clinically symptomatic uterine fibroids in patients with abnormal uterine bleeding causes.