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目的:研究分析子宫内膜异位症异位内膜雌激素产生、代谢的具体情况。方法:通过RT-PCR、免疫组化法对134例卵巢子宫内膜异位囊肿患者进行检测,观察异位子宫内膜、在位内膜组织中17β-HSDⅡmRNA、蛋白质、P450A mRNA的表达,同时与70例正常子宫内膜情况相对比。结果:70例健康者正常子宫内膜没有P450 AmRNA、17β-HSD II mRNA在增生晚期的微量表达,在分泌期晚期升至高峰;在位内膜显示P450AmRNA的微弱表达,而17β-HSD II mRNA的表达情况近似于正常子宫内膜,强度比较小。134例卵巢异位内膜均发现P450A mRNA的表达,但是17β-HSD II mRNA的表达不足。结论:子宫内膜异位症患者的异位内膜可以产生雌激素,但是存在局部雌激素代谢缺陷,所形成的雌激素微环境是造成异位内膜生长的重要因素。
Objective: To study the specific situation of ectopic endometrial estrogen production and metabolism in endometriosis. Methods: 134 cases of ovarian endometriosis were detected by RT-PCR and immunohistochemistry. The expressions of 17β-HSDⅡmRNA, protein and P450A mRNA in ectopic endometrium and eutopic endometrium were observed. Compared with 70 cases of normal endometrium. RESULTS: There were no P450 AmRNA in normal endometrium and 17β-HSD II mRNA in late stage of hyperplasia, which peaked in the late secretory phase. The eutopic endometrium showed weak expression of P450A mRNA, while the expression of 17β-HSD II mRNA The expression of similar to the normal endometrium, the intensity is relatively small. 134 cases of ovarian ectopic endometrial were found P450A mRNA expression, but the expression of 17β-HSD II mRNA is not enough. Conclusion: Ectopic endometrium of patients with endometriosis can produce estrogen, but there is local estrogen metabolism defect. The estrogen microenvironment formed is an important factor to cause ectopic endometrial growth.