【摘要】 目的探讨DNA结合抑制因子(Id)-1在各期子宫内膜异位症(EMS)在位及异位内膜中的表达及意义。方法选择2013年1月至6月因不孕症或盆腔包块于珠海市妇幼保健院妇科就诊并住院的73例患者为研究对象。按照组织病理学检查结果,将其分为实验组和对照组。其中,经组织病理学检查证实为EMS的在位及异位内膜标本各50例(分别包括增殖期子宫内膜标本28例及分泌期子宫内膜标本22例)纳入实验组,同时,以23例非EMS患者的正常子宫内膜标本(包括增殖期子宫内膜标本14例及分泌期子宫内膜标本9例)纳入对照组(本研究遵循的程序符合珠海市妇幼保健院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象知情同意,并与之签署临床研究知情同意书)。所有标本分别采用免疫组织化学技术SP法和实时荧光定量PCR法检测Id-1蛋白和mRNA的表达,并分析其表达水平在各期EMS及月经周期的差异。各组患者一般情况比较,其差异无统计学意义(P>0.05)。结果实验组EMS在位内膜标本的Id-1蛋白表达阳性率和mRNA相对表达量明显高于对照组,且差异有统计学意义(χ2=11.585,P=0.009;t=13.585,P=0.000);EMS在位内膜标本的Id-1蛋白表达阳性率和mRNA相对表达量低于EMS异位内膜组,且差异有统计学意义(χ2=9.860,P=0.020;t=0.485,P=0.001)。对不同分期EMS在位内膜标本的Id-1蛋白和mRNA表达水平进行比较,Ⅲ~Ⅳ期子宫内膜标本比Ⅰ~Ⅱ期高,且差异有统计学意义(χ2=9.839,P=0.020;t=9.708,P=0.000);对不同分期EMS异位内膜的Id-1蛋白和mRNA表达水平进行比较,Ⅲ~Ⅳ期子宫内膜标本比Ⅰ~Ⅱ期高,且差异有统计学意义(χ2=10.110,P=0.018;t=9.577,P=0.000)。正常子宫内膜、EMS在位及异位内膜的增殖期和分泌期Id-1蛋白及mRNA表达水平比较,其差异均无统计学意义(P>0.05)。结论 Id-1高表达与EMS的发生、发展密切相关,其表达水平与月经周期无关。更多还原

【Abstract】 Objective To investigate the expression and significance of inhibitors of DNA binding(Id)-1 in the eutopic and ectopic endometria of endometriosis(EMS)patients at different stages.Methods A total of 73 inpatients visiting Gynecology department for infertility or pelvic cavity bump from January 2013 to June 2013 were selected as the subjects.Among them,50 eutopic and ectopic endometria samples were pathologically-diagnosed EMS as experiment group(28 cases in the proliferative phase and 22 cases in the secretory phase,respectively)and 23 cases normal endometria samples with non-EMS as control group(14 cases in the proliferative phase and 9 cases in the secretory phase).The study protocol was approved by the Ethical Review Board of Zhuhai Maternity and Child Health Hospital.Informed consent was obtained from all participants.The expressions of Id-1 protein and mRNA in all samples were separately detected by immunohistochemical SP method and real-time fluorescent quantitative PCR,and the expression level differences in different EMS phases and menstruation cycle were analyzed.The general clinic data of each group had no significant difference(P>0.05).Results The positive expression rate of Id-1 protein and the relative expression amount of mRNA in the eutopic endometria samples of the EMS group were significantly higher than those of the control group(χ2=11.585,P=0.009;t=13.583,P=0.000);while they were significantly lower than those in the ectopic endometria samples of the EMS group(χ2=9.860,P=0.020;t=0.485,P=0.001).The expression level of Id-1protein and mRNA of eutopic endometria samples at stage Ⅲ~Ⅳ were significantly higher than that of those at stageⅠ~Ⅱ(χ2=9.839,P=0.020;t=9.708,P=0.000);The same was true of the ectopic endometria samples(χ2=10.110,P=0.018;t=9.577,P=0.000).At the proliferative phase and secretory phase,the expression level of Id-1protein and mRNA of all samples in each group showed no significant differences(P>0.05).Conclusions Overexpression of Id-1 is closely related to the pathogenesis and development of EMS,whereas its expression level has nothing to do with the menstruation cycle.更多还原