【作者】 张菁；

【导师】 赵兴波；

【作者基本信息】 山东大学 ， 妇产科学， 2011， 硕士

【摘要】 [目的]目前认为子宫腺肌病是由子宫内膜基底层向子宫肌层内生长或内陷所致,可能与高雌激素或高催乳激素刺激、免疫、血管生成、激素受体蛋白、细胞凋亡及遗传等因素有关,但是其确切发病机制目前尚未完全明了。SPAG9是睾丸癌症抗原家族的新成员,在生物过程中发挥重要的调控作用,包括细胞的增殖、分化、凋亡、免疫细胞的功能、胚胎形态的发生和肿瘤的发展。子宫腺肌病的发病机制是否与SPAG9相关,目前尚不了解。本研究旨在检测SPAG9在子宫腺肌病组织中的表达,探讨SPAG9可能在子宫腺肌病发生发展的作用及临床治疗意义。[方法]以临床获取的标本子宫腺肌病异位灶、子宫腺肌病在位内膜和正常内膜组织为研究对象。采用免疫组化SP法检测子宫腺肌病病灶(20例)、在位内膜(20例)、正常子宫内膜(20例)标本的腺上皮细胞和间质细胞中SPAG9的表达并进行比较性研究。[结果]SPAG9在观察组子宫腺肌病异位内膜、在位内膜腺上皮细胞中的表达较对照组正常子宫内膜明显增强,差异均有统计学意义(P均<0.01)；异位内膜与在位内膜组间：SPAG9表达差异无统计学意义(P>0.05)。间质细胞中无或少量SPAG9的表达。增生期和分泌期各对应组别之间比较SPAG9表达阳性率无显著性差异(P>0.05)。观察组中有3例术前3月接受激素(2例放置曼月乐、1例服用孕三烯酮、米非司酮)治疗者较其他17例未用药者表达强度减低(P<0.05)[结论]SPAG9在子宫腺肌病病灶中呈高表达提示其可能参与子宫腺肌病的发生与发展过程,为子宫腺肌病的诊断检测和治疗提供了新的靶点。更多还原

【Abstract】 [Objective] Adenomyosis is generally believed that adenomyosis develops as a result of downgrowth and invagination of the basalis endometrium into the myometrium. The pathogenesis of adenomyosis might be correlated with the factors of immune, vascular formation, neurophysin receptor, apoptosis and heredity. However, the exact mechamisms of adenomyosis are not yet very clear. Sperm associated antigen 9 (SPAG9), is a new member of the caner testis antigen family, known to play a major role in cell growth, proliferation, apoptosis, the function of immune cells, embryogenesis and tumor development. It is not understood that if the expression of SPAG9 is related to adenomyosis. We investigate the expressions of SPAG9 in adenomyosis tissues to learn its role in the development of adenomyosis, these studies will be very important to the clinical treatment of adenomyosis.[Materials and Methods] Taking the ectopic foci of adenomyosis, adenomyosis and normal eutopic endometrial tissues from clinical speciments as the research object. The expressions of SPAG9 protein in the ectopic lesions with myometrium of adenomyosis group (20 cases), the eutopic endometrium group(20 cases), and the normal endometrium group(20 cases) were detected by SP immunohistochemistry, and were compared with eachother.[Results] SPAG9 could express either in ectopic or eutopic endometrium with adenomyosis. SPAG9 expressions in ectopic, eutopic endometrium with adenomyosis were both significantly higher than that of control group (P<0.01); No statistically significant difference was found between in ectopic endometrium and eutopic endometrium (P>0.05). The expression of SPAG9 in adenomyosis ectopic and eutopic endometrium was significantly higher than normal endometrium (P<0.01). There was no significant difference between ectopic endometrium and eutopic endometrium in the observation group (P>0.05). There was no or a few SPAG9 expression in the stromal cells. The difference between proliferative phase endometrium and secretory phase endometrium in every group was not significant (P>0.05). SPAG9 expressions in the three cases of the observation group accepting hormone treatment 3 months before the experiment (2 cases placed mirena,1 case took gestrinone and mifepristone) was lower than the other 17 non-users (P< 0.05).[Conclusion] SPAG9 in adenomyosis lesions showed high expression, which may be one of the mechanisms of the occurrence and development process. It also bring a new target for the diagnosis, detection and treatment of adenomyosis.更多还原