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目的:探讨神经生长因子(NGF)及其受体TrkA和p75在子宫内膜异位症病灶中的表达及与患者疼痛之间的关系。方法:2008年6月至2011年6月就诊于浙江大学附属妇产科医院和杭州市第一人民医院的住院病例97例子宫内膜异位症(EMs)患者,其中宫骶韧带深部浸润型子宫内膜异位结节(DIE)35例、卵巢子宫内膜异位囊肿(OEM)42例及腹壁子宫内膜异位结节(AEM)20例,术前采用视觉模拟(VAS)评分法进行术前疼痛评分,入组病例为评分在10分或0分的病例,并因此分为疼痛组和无疼痛组(AEM未收集到无疼痛病例)。组织标本应用免疫组织化学法检测患者病灶中NGF、TrkA及p75的的蛋白表达,同时选择16例同期子宫肌瘤且不伴疼痛患者的宫骶韧带组织作为对照进行研究。结果:NGF、TrkA和p75在DIE、AEM及OEM 3种EMs病灶的表达均高于正常宫骶韧带组织(P<0.01),NGF和p75在DIE病灶的表达高于AEM和OEM(P<0.05)。p75在DIE、OEM疼痛患者和无疼痛患者病灶的表达差异具有统计学意义(P<0.05或P<0.01);而NGF和TrkA在DIE、OEM疼痛患者和无疼痛患者病灶的表达差异无统计学意义(P>0.05)。结论:NGF及其受体TrkA及p75可能参与子宫内膜异位症的发生和发展,DIE和NGF、p75密切相关,p75可能与EMs疼痛的发生有关。
Objective: To investigate the expression of nerve growth factor (NGF) and its receptors TrkA and p75 in endometriosis lesions and its relationship with pain. Methods: From June 2008 to June 2011, 97 patients with endometriosis (EMs) were enrolled in the inpatient department of Affiliated Obstetrics and Gynecology Hospital of Zhejiang University and First People’s Hospital of Hangzhou City, in which the deep infiltration of uterosacral ligaments Thirty-five cases of endometriotic nodules (DIE), 42 cases of ovarian endometriosis (OEM) and 20 cases of abdominal wall endometriosis (AEM) were included in this study. The visual analogue (VAS) Preoperative pain scores were assigned to enrolled patients with a score of 10 or 0 and were therefore divided into pain and no pain groups (no pain was not detected in the AEM). Immunohistochemistry was used to detect the protein expression of NGF, TrkA and p75 in the lesion, and the uterine fibroids in 16 patients with uterine leiomyoma without pain were selected as the control. Results: The expressions of NGF, TrkA and p75 in DIE, AEM and OEM EMs were significantly higher than those in normal uterosacral ligaments (P <0.01). The expression of NGF and p75 in DIE lesions was higher than that in AEM and OEM (P <0.05) ). There was significant difference in the expression of p75 between DIE, OEM and non-pain patients (P <0.05 or P <0.01), while there was no significant difference in the expression of NGF and TrkA between DIE, OEM pain patients and non-pain patients Significance (P> 0.05). Conclusion: NGF and its receptors TrkA and p75 may be involved in the occurrence and development of endometriosis. DIE is closely related to NGF and p75, and p75 may be related to the occurrence of EMs pain.