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目的:观察纤溶酶原激活因子及纤溶酶原激活物抑制因子(PA/PAI)在子宫肌瘤及子宫平滑肌组织及原代细胞中表达的差异,为腹腔镜子宫动脉阻断术治疗子宫肌瘤提供理论依据。方法:组织学:采用荧光定量PCR检测子宫肌瘤及子宫平滑肌组织中组织型纤溶酶原激活因子(t-PA)和尿激酶型纤溶酶原激活因子(u-PA)以及纤溶酶原激活物抑制因子(PAI-1)的表达;用免疫组织化学方法检测3种蛋白的表达;细胞学:选取8例子宫肌瘤患者,分别培养子宫肌瘤及子宫平滑肌细胞并传代,应用实时定量PCR及免疫细胞检测u-PA及PAI-1。结果:组织学:(1)肌瘤组织中u-PA mRNA相对表达为(1.34±2.18)%,显著低于平滑肌组织的(2.84±2.97)%,差异有统计学意义(P<0.05);t-PAmRNA在肌瘤组织中表达为(1.46±1.64)%也低于平滑肌组织的(1.65±3.08)%,但差异无统计学意义(P>0.05)。PAI-1 mRNA在肌瘤组织中的表达为(2.67±1.82)%,显著高于平滑肌组织的(1.27±1.99)%,差异有统计学意义(P<0.05);(2)肌瘤组织u-PA蛋白表达显著低于平滑肌组织,差异有统计学意义(P<0.05);肌瘤组织PAI-1蛋白表达显著高于平滑肌组织(P<0.01);两种组织t-PA蛋白表达差异无统计学意义(P>0.05)。细胞学:(1)肌瘤细胞中u-PA mRNA相对表达为0.123±0.189,显著低于平滑肌细胞的0.331±0.306,差异有统计学意义(P<0.05);PAI-1 mRNA在肌瘤细胞的表达为0.091±0.036,显著高于平滑肌细胞的0.016±0.020,差异有统计学意义(P<0.05);(2)肌瘤细胞u-PA蛋白表达8.805±1.645显著低于平滑肌细胞的22.173±4.381,差异有显著的统计学意义(P<0.05);肌瘤细胞PAI-1蛋白表达44.765±1.090显著高于平滑肌细胞35.928±5.351(P<0.05)。结论:PA/PAI系统在子宫肌瘤及平滑肌细胞中表达存在差异,并与组织中的差异基本一致,提示该系统差异表达机制可以为腹腔镜子宫动脉阻断术治疗子宫肌瘤提供理论依据。
OBJECTIVE: To observe the differences of PA / PAI expression in uterine fibroids and uterine smooth muscle and primary cells, and to evaluate the effect of laparoscopic uterine artery occlusion on the uterus Fibroids provide a theoretical basis. Methods: Histology: Tissue plasminogen activator (t-PA) and urokinase-type plasminogen activator (u-PA) and plasminogen activator (uPA) in uterine leiomyoma and uterine smooth muscle were detected by real- The expression of PAI-1 was detected by immunohistochemistry. The expression of three proteins was detected by immunohistochemistry. Cytology: Eight patients with uterine leiomyomas were selected and cultured. The uterine fibroids and uterine smooth muscle cells were cultured and passaged respectively. Quantitative PCR and immune cells detected u-PA and PAI-1. RESULTS: Histology: (1) The relative expression of u-PA mRNA was (1.34 ± 2.18)% in fibroid tissue, which was significantly lower than that in smooth muscle tissue (2.84 ± 2.97)%, the difference was statistically significant (P <0.05). The expression of t-PA mRNA in myoma was (1.46 ± 1.64)% lower than that in smooth muscle (1.65 ± 3.08)%, but the difference was not statistically significant (P> 0.05). The expression of PAI-1 mRNA in myoma was (2.67 ± 1.82)%, which was significantly higher than that in smooth muscle (1.27 ± 1.99)%, the difference was statistically significant (P <0.05). (2) (P <0.05). The PAI-1 protein expression in fibroid tissue was significantly higher than that in smooth muscle tissue (P <0.01). There was no significant difference in t-PA protein expression between the two groups Statistical significance (P> 0.05). Cytology: (1) The relative expression of u-PA mRNA in fibroids was 0.123 ± 0.189, which was significantly lower than that in smooth muscle cells (0.331 ± 0.306, P <0.05) (0.091 ± 0.036), which was significantly higher than that of smooth muscle cells (0.016 ± 0.020) (P <0.05). (2) The u-PA protein expression in fibroid cells was significantly lower than that in smooth muscle cells 4.381, the difference was statistically significant (P <0.05). The PAI-1 protein expression in fibroids was 44.765 ± 1.090, which was significantly higher than that in smooth muscle cells (35.928 ± 5.351, P <0.05). Conclusions: The expression of PA / PAI system in uterine fibroids and smooth muscle cells is different, which is consistent with the difference in tissue, suggesting that the differential expression mechanism of PA / PAI system can provide a theoretical basis for the treatment of uterine fibroids by laparoscopic uterine artery occlusion.