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目的:探讨子宫腺肌病患者在位子宫内膜、异位子宫内膜中雌激素受体alpha(ERα)、雌激素受体beta(ERβ)和基质金属蛋白酶-1(MMP-1)的表达及其对子宫腺肌病发病的影响。方法:收集子宫腺肌病患者在位内膜40例、异位内膜40例、同期行子宫肌瘤手术的正常子宫内膜40例为对照组。采用免疫组织化学方法检测和分析ERα、ERβ和MMP-1的表达。结果:MMP-1和ERα在子宫腺肌病异位内膜的腺体和间质中的表达分别呈高表达和低表达状态,与子宫腺肌病的在位内膜和正常内膜比较,差异有统计学意义;在异位内膜中ERβ的表达明显高于ERα;MMP-1和ERβ的表达存在相关性;ERα、ERβ和MMP-1在在位内膜和正常内膜比较差异无统计学意义。结论:MMP-1和ERβ可能共同参与子宫腺肌病的发生与发展。在异位内膜中ERβ/ERα比例的变化可能提示局部激素受体微环境的改变在子宫腺肌病发生中起重要的作用。
Objective: To investigate the expression of estrogen receptor alpha (ERα), estrogen receptor beta (ERβ) and matrix metalloproteinase-1 (MMP-1) in patients with adenomyosis and ectopic endometrium And its impact on the incidence of adenomyosis. Methods: Forty patients with adenomyosis and 40 ectopic endometrium were collected, and 40 cases of normal endometrium underwent uterine fibroid surgery in the same period as the control group. The expressions of ERα, ERβ and MMP-1 were detected by immunohistochemistry. Results: The expressions of MMP-1 and ERα in the gland and stroma of ectopic endometrium of adenomyosis were highly expressed and lowly expressed, respectively. Compared with the eutopic endometrium and normal endometrium of adenomyosis, The difference was statistically significant; the expression of ERβ in ectopic endometrium was significantly higher than that in ERα; the expression of MMP-1 and ERβ was correlated; the difference of ERα, ERβ and MMP-1 in eutopic and normal endometrium Statistical significance. Conclusion: MMP-1 and ERβ may participate in the occurrence and development of adenomyosis. The change of ERβ / ERα ratio in ectopic endometrium may indicate that the change of local hormone receptor microenvironment plays an important role in the development of adenomyosis.