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目的:观测子宫腺肌病异位子宫内膜组织COX-2和VEGF表达及其临床意义。方法:34例经病理证实为子宫腺肌病标本为研究组,30例非子宫腺肌病子宫标本为对照组。采用免疫组化法检测研究组原位内膜和腺肌病病灶、对照组内膜和子宫平滑肌层中COX-2和VEGF的表达。采用RT-PCR检测COX-2mRNA和VEGFmRNA的表达。结果:COX-2和VEGF在研究组原位内膜和腺肌病病灶中的表达率均高于对照组内膜,研究组腺肌病病灶表达率均高于原位内膜(P<0.01)。增殖期和分泌期二者在腺肌病病灶表达率均无统计学差异(P>0.05)。分泌期二者在研究组和对照组中内膜的表达均高于增殖期(P<0.05)。COX-2和VEGF蛋白表达存在线性相关(r=0.787,0.562,P<0.01)。RT-PCR检测表明,COX-2mRNA在研究组腺肌病病灶存在高表达,对照组肌层和内膜不存在COX-2mRNA表达。比较对照组正常肌层,腺肌病病灶中VEGF165和VEGF121呈现高表达(P<0.01)。结论:COX-2和VEGF的高表达可能与子宫腺肌病的发生、发展有关。
Objective: To observe the expression of COX-2 and VEGF in ectopic endometrium of adenomyosis and its clinical significance. Methods: 34 cases of pathological confirmed adenomyosis specimens for the study group, 30 cases of non-adenomyosis uterus specimens for the control group. Immunohistochemistry was used to detect the expression of COX-2 and VEGF in the intima and adenomyosis lesions of the study group, the control group and the uterine smooth muscle layer. The expression of COX-2 mRNA and VEGF mRNA were detected by RT-PCR. Results: The expression rates of COX-2 and VEGF in the in situ and adenomyosis lesions of the study group were higher than those of the control group, and the expression rates of the study group were higher than those of the in situ endometrium (P <0.01) ). There was no significant difference in proliferative phase and secretory phase between adenomyosis lesions (P> 0.05). Endometrium expression in both study group and control group was higher than that in proliferative phase (P <0.05). There was a linear correlation between COX-2 and VEGF protein expression (r = 0.787,0.562, P <0.01). The results of RT-PCR showed that COX-2 mRNA was highly expressed in the myogenic lesions of the study group, while there was no expression of COX-2 mRNA in the muscle and intima of the control group. VEGF165 and VEGF121 in adenomyosis lesions showed high expression in normal myometrium (P <0.01). Conclusion: The high expression of COX-2 and VEGF may be related to the occurrence and development of adenomyosis.