【作者】 周军；

【导师】 田永杰；

【作者基本信息】 山东大学 ， 妇产科学， 2005， 硕士

【摘要】 目的:观测子宫腺肌病异位子宫内膜组织COX-2、VEGF和微血管密度(MVD)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(增殖期18例,分泌期16例)为观测组,以30例非子宫腺肌病子宫标本为正常对照组。采用免疫组化法检测子宫腺肌病原位和异位子宫内膜、子宫平滑肌层中COX-2、VEGF蛋白和微血管密度(MVD)。采用原位杂交法检测COX-2和VEGFmRNA表达。采用RT-PCR检测COX-2mRNA和VEGFmRNA的表达。应用SPSS10.0软件进行方差分析和均数t检验。 结果:子宫腺肌病增殖期和分泌期原位和异位内膜COX-2蛋白表达高于对照组;异位内膜高于原位内膜(p<0.01);增殖期和分泌期表达率无明显差异(p>0.05);异位内膜病灶周围肌层表达率为76.47%,而正常子宫肌层不存在表达。 子宫腺肌病增殖期和分泌期原位和异位内膜VEGF蛋白表达率高于对照组;异位内膜高于原位内膜(p<0.05):增殖期和分泌期异位内膜表达率无显著差异(p>0.05)。原位内膜分泌期表达高于增殖期(p<0.05)。异位内膜病灶周围肌层表达高于对照组(p<0.05)。COX-2和VEGF蛋白表达存在相关性(r=0.787和r=0.562,p<0.01)。 子宫腺肌病异位和原位内膜MVD高于对照组,异位内膜高于原位内膜(p<0.01)。COX-2、VEGF和MVD表达呈正相关。 原位杂交和RT-PC检测表明,COX-2mRNA表达定位于腺体细胞、病灶肌层和血管内皮细胞内。异位内膜和病灶肌层高于原位内膜(p<0.01);异位内膜和更多还原

【Abstract】 Objective: To investigate the expression and clinical significance of MVD,COX-2 and VEGF in the adenomyosis.Methods: 34 cases of adenomyosis that were evaluated by pathological examination were as observed group, and 30 cases of non-adenomyosis samples of the uterus were as control group. The immunohistochemistry was used to observe the expression of COX-2, VEGF protein and MVD in the eutopic and ectopic endometrium of the adenomyosis and the smooth muscle of the uterus. The hybridization in situ and RT-PCR were used to measure the expression of COX-2 and VEGFmRNA in the adenomyosis. normal endometrium and muscle layer of the uterus. The statistical analysis methods were SPSS 10.0 software of the variance analysis and mean t-test.Results: The expression of COX-2 protein in the eutopic and ectopic endmetrium of the proliferative and secretory phase in the adenomyosis was higher than that of control group. The expression of the endometrium in proliferative phase was higher than that of the secretory phase,and the expression of ectopic endometrium was higher than that of the eutopic endometrium (p<0.01) .The expression rate between the proliferative phase and the secretoruy phase had not significant differencet (p>0.05) ; The expression of the musclar layer around the lesion of ectopic endometrium in the adenomyosis was 76.47%, but there was no the expression in normal musclar layer of the uterus.The expression rate of VEGF protein in the eutopic and ectopic endmetrium ofthe proliferative and secretory phase in the adenomyosis was higher than that of control group (p<0.05) .The expression rate of ectopic endometrium was higher than that of eutopic endometrium. The expression rate between the proliferative phase and the secretory phase had not significant difference (p>0.05) .The expression rate of eutopic endometrium of the secretory phase was higher than that of the proliferative phase (p<0.05) .The expression of the musclar layer around the lesion of ectopic endometrium in adenomyosis was higher than that of control group (p<0.05) .There was the relationship between the expression of COX-2 and VEGF protein (r=0.787 and r=0.562, p<0.01) . The MVD of the ectopic and eutopic endometrium in the adenomyosis was higher than that of control group (p<0.01) . There was positive relationship of the expression of COX-1, VEGF and MVD.The hybridization in situ and RT-PCR demonstrated that the expression of C0X-2mRNA was located in the plasma of glandular cell,the musclar layer around the ectopic endometrial lesions and vascular epithelial cells. The expression rate of ectopic endometrium and the muscle around ectopic endometrial lesions was higher than that of eutopic endoemtrium(p<0.01 ),but the expression rate between the ectopic endometrium and the muscle layer around ectopic endometrial lesions had not significant difference (p>0.05 ) .There was no the expression of C0X-2mRNA in the normal muscle layer and the endometrium ,but the expression of VEGFmRNA, VEGF 165 and VEGF121 was enhanced in the ectopic endometrium of the adenomyosis.Conclusions: There was higher expression of COX-2.. C0X-2mRNA> VEGF^ VEGFmRNA and MVD in the ectopic endometriun of the adenomyosis, and their expression had a positive relationship.更多还原