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目的探讨Toll样受体-4(Toll-like receptor 4,TLR4)、激活蛋白-1(activator protein-1,AP-1)与子宫内膜异位症(EMs)之间的关系以及相关性。方法选择2011年9月-2012年4月在该院经病理证实为卵巢EMs患者的异位内膜45例(Ⅰ~Ⅱ期15例,Ⅲ~Ⅳ期30例),并同时获得其在位内膜30例,同期因子宫畸形行宫腔镜手术患者的正常内膜30例为对照组。采用半定量RT-PCR及免疫组化技术(SP法)检测TLR4及AP-1在上述各组组织中的表达情况。结果 TLR4和AP-1蛋白主要在腺体上皮细胞表达,间质细胞也有表达,TLR4蛋白主要在细胞胞浆和胞膜表达,AP-1蛋白主要在细胞胞质和胞核表达。TLR4及AP-1的mRNA和蛋白在EMs患者异位内膜、在位内膜的表达均明显高于对照组,差异有统计学意义(P<0.01);EMs患者异位内膜中的表达明显高于在位内膜,差异有统计学意义(P<0.01);在EMsⅠ~Ⅱ期和Ⅲ~Ⅳ期患者异位内膜中的表达无明显差异(P>0.05);TLR4和AP-1在EMs患者在位内膜和异位内膜组的表达均呈正相关。结论 TLR4及AP-1的高表达可能在EMs的发病机制中起着重要作用。
Objective To investigate the relationship between Toll-like receptor 4 (TLR4), activator protein-1 (AP-1) and endometriosis (EMs). Methods Forty-five cases of ectopic endometrium with ovarian EMs confirmed by pathology in our hospital from September 2011 to April 2012 were selected (15 cases in stage Ⅰ ~ Ⅱ and 30 cases in stage Ⅲ ~ Ⅳ), and their eutopic end points 30 cases of endometrium, the same period due to uterine malformations of hysteroscopic surgery in patients with normal endometrium in 30 cases for the control group. Semi-quantitative RT-PCR and immunohistochemistry (SP method) were used to detect the expression of TLR4 and AP-1 in the above groups. Results TLR4 and AP-1 protein were mainly expressed in glandular epithelial cells and interstitial cells. TLR4 protein was mainly expressed in cytoplasm and plasma membrane. AP-1 protein was mainly expressed in cytoplasm and nucleus of cells. The mRNA and protein expressions of TLR4 and AP-1 in ectopic endometrium and eutopic endometrium in patients with EMs were significantly higher than those in the control group (P <0.01); The expression of ectopic endometrium (P <0.01). There was no significant difference in the expression of ectopic endometrium between EMsⅠ ~ Ⅱand Ⅲ ~ Ⅳ (P> 0.05). The expressions of TLR4 and AP- 1 in eutopic endometrium and ectopic endometrium in patients with EMs were positively correlated. Conclusion The high expression of TLR4 and AP-1 may play an important role in the pathogenesis of EMs.