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目的研究基质金属蛋白酶9(MMP-9)和微血管生成在子宫内膜异位症组织中表达的变化及其表达与患者的月经周期及临床分期的关系。方法应用免疫组织化学法检测20例患者卵巢异位内膜、在位内膜及正常内膜中MMP-9,CD34的表达,并根据CD34在血管中的表达计算组织的微血管密度(MVD)。结果 1MMP-9在异位内膜组表达最高,在位内膜组次之,正常内膜组最低;2在位内膜组及正常内膜组MMP-9表达分泌期高于增殖期。异位内膜组增殖期与分泌期表达相近,且均高于相应期别的对照组;3MMP-9在异位内膜组、在位内膜组的表达Ⅲ-Ⅳ期高于Ⅰ-Ⅱ期;4MVD在异位内膜组表达最高。在位内膜组及正常内膜组表达相近;5在位内膜组及正常内膜组中,MVD的表达增殖期与分泌期相近;异位内膜组增殖期与分泌期内膜表达相近,并均高于相应期别的对照组;6异位内膜组MVD的表达Ⅲ-Ⅳ期高于Ⅰ-Ⅱ期。在位内膜组Ⅲ-Ⅳ期与Ⅰ-Ⅱ期相近。7异位内膜组、在位内膜组、正常内膜组MMP-9的表达强度与MVD的表达量呈正相关。结论 MMP-9、微血管生成参与了子宫内膜异位种植、侵袭、浸润、血管形成过程,为子宫内膜异位症的辅助治疗提供理论依据。
Objective To investigate the expression of matrix metalloproteinase 9 (MMP-9) and angiogenesis in endometriosis and its relationship with the menstrual cycle and clinical stage. Methods Immunohistochemical method was used to detect the expression of MMP-9 and CD34 in ectopic endometrium, eutopic endometrium and normal endometrium of 20 patients. MVD was calculated according to the expression of CD34 in blood vessels. Results The expression level of MMP-9 in eutopic endometrium group and normal endometrium group was higher than that in proliferative phase in eutopic endometrium group and normal endometrium group. The expression of 3MMP-9 in ectopic endometrium group and eutopic endometrium group was higher than that of Ⅰ-Ⅱ 4MVD was the highest expression in ectopic endometrium group. Eutopic endometrium group and normal endometrium group were similar; 5 eutopic endometrium group and normal endometrium group, MVD expression of proliferative phase and secretory phase similar; ectopic endometrium proliferative phase and secretory endometrium expression were similar , All of which were higher than that of the corresponding control group. 6 The expression of MVD in ectopic endometrium was higher than that in stageⅠ-Ⅱ. The eutopic endometrium group Ⅲ-Ⅳ and Ⅰ-Ⅱ phase similar. 7 ectopic endometrium group, eutopic endometrium group, normal endometrium group MMP-9 expression intensity and MVD expression was positively correlated. Conclusion MMP-9 and micro-angiogenesis are involved in the process of endometriosis implantation, invasion, invasion and angiogenesis, which provide a theoretical basis for the adjuvant therapy of endometriosis.