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目的探讨肥大细胞类胰蛋白酶(MCT)及类糜蛋白酶(MCC)在绝经前、后子宫内膜息肉组织(EP)中的表达及临床意义。方法收集120例患者标本,其中绝经前EP组和绝经后EP组各35例,绝经前正常增生期子宫内膜组和绝经后正常萎缩性子宫内膜组各25例。采用Max VisionTM/HRP免疫组织化学染色法,检测各组中MCT及MCC阳性的肥大细胞(MCs)数量并分析临床意义。结果绝经前、后EP组和正常子宫内膜组中MCT和MCC阳性的MCs计数均值分别为高倍镜下(11.82±5.24)个和(2.94±2.20)个、(4.18±2.32)个和(2.18±1.52)个、(2.19±1.80)个和(0.49±0.60)个以及(0.35±0.32)个和(0.19±0.26)个。两两比较结果显示,绝经前、后EP组MCT和MCC阳性的MCs数量明显高于同期正常子宫内膜组(P<0.05);在EP组中,MCT阳性的MCs数量在绝经前高于绝经后(P<0.05),而MCC阳性的MCs数量没有明显差异(P>0.05);在正常子宫内膜组中,MCT和MCC阳性的MCs数量在绝经前均高于绝经后(P<0.05)。结论肥大细胞(MCs)的过度活化以及伴随的炎症性损害可能是绝经前、后子宫内膜息肉形成及发展的原因。
Objective To investigate the expression and clinical significance of mast cell tryptase (MCT) and chymase (MCC) in pre and postmenopausal women with endometrial polyps (EP). Methods Totally 120 patients were collected, including 35 cases of premenopausal EP group and 50 cases of postmenopausal EP group, 25 cases of premenopausal normal proliferative endometrium group and 25 cases of postmenopausal normal atrophic endometrium group respectively. Max VisionTM / HRP immunohistochemical staining was used to detect the number of MCT and MCC positive MCs in each group and to analyze the clinical significance. Results The mean MCS counts of MCT and MCC in pre-menopausal and post-menopausal women with EP and normal endometrium were (11.82 ± 5.24) and (2.94 ± 2.20), (4.18 ± 2.32) and (2.18 ± 1.52), (2.19 ± 1.80) and (0.49 ± 0.60) and (0.35 ± 0.32) and (0.19 ± 0.26), respectively. The results of comparison showed that the number of MCS and MCC positive MCs in premenopausal and postmenopausal women with EP was significantly higher than that in normal endometrium (P <0.05). In EP group, the number of MCT positive MCs was higher in premenopausal menopause (P <0.05), while the number of MCC positive MCs had no significant difference (P> 0.05). In the normal endometrium group, the number of MCT and MCC positive MCs in premenopausal group was higher than that in postmenopausal group (P <0.05) . Conclusion The overactivation of mast cells (MCs) and the accompanying inflammatory damage may be responsible for the formation and development of endometrial polyps before and after menopause.