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目的:探讨雌激素介导的上皮-间质转换在子宫内膜异位症发生发展中的作用。方法:选择2009年1月～2012年1月在重庆市西郊医院进行手术治疗并诊断为子宫内膜异位症的50例患者作为实验组(EMS组),选择同期健康体检者40例作为对照组。应用免疫组织化学、Western blot方法检测在位子宫内膜以及异位内膜标本中上皮细胞的标志分子E-cadherin和基质细胞标志分子Vimentin的表达,同时检测血清中雌二醇水平。结果:异位内膜上皮细胞中E-cadherin表达阳性率为20.00%,在位内膜为38.00%,明显低于正常对照组(P<0.01)。异位内膜上皮细胞中Vimentin的表达阳性率为74.00%,在位内膜为54.00%,明显高于正常对照组(P<0.01)。Western blot结果表明,异位内膜组织中E-cadherin表达量明显低于正常内膜组织,而Vimentin明显高于正常内膜组织(P<0.001)。内异症患者分泌中期血清中雌二醇水平明显高于正常对照组(P<0.001)。结论:内异症患者异位内膜和在位内膜上皮细胞的标志分子E-cadherin表达降低,而基质细胞标志分子Vimentin表达上调,说明上皮-间质转换过程与子宫内膜异位症发生相关,而且雌激素可能参与了介导子宫内膜上皮细胞发生间质转换的过程。
Objective: To investigate the role of estrogen-mediated epithelial-mesenchymal transition in the development of endometriosis. Methods: Fifty patients with endometriosis undergoing surgical treatment in the western suburbs of Chongqing from January 2009 to January 2012 were selected as the experimental group (EMS group), and 40 healthy subjects Control group. Immunohistochemistry and Western blot were used to detect the expression of E-cadherin and Vimentin, a marker of epithelial cells in endometriosis and ectopic endometrium, respectively. Serum estradiol levels were also measured. Results: The positive rate of E-cadherin in ectopic endometrial epithelial cells was 20.00%, and the eutopic endometrium was 38.00%, which was significantly lower than that of the normal control group (P <0.01). The positive expression rate of Vimentin in ectopic endometrial epithelial cells was 74.00%, and the eutopic endometrium was 54.00%, which was significantly higher than that of the normal control group (P <0.01). Western blot results showed that the expression of E-cadherin in ectopic endometrium was significantly lower than that in normal endometrium, while Vimentin was significantly higher than that in normal endometrium (P <0.001). Endometriosis secretion of midterm serum estradiol levels were significantly higher than the normal control group (P <0.001). Conclusion: The expression of E-cadherin, a marker of eutopic endometrium and eutopic endometrial epithelial cells in patients with endometriosis, is decreased, while the expression of Vimentin, a marker of stromal cells, is up-regulated, indicating that epithelial-mesenchymal transition process and endometriosis occur Related, and estrogen may be involved in the process of mediating mesenchymal transition in endometrial epithelial cells.