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目的检测子宫内膜异位症在位子宫内膜Bcl- 2的表达 ,探讨其在子宫内膜异位症发生机制中的作用。方法采用免疫组织化学法 (SP法 )对 45例盆腔子宫内膜异位症和 44例壁间型子宫肌瘤患者在位子宫内膜进行Bcl- 2表达检测。结果 (1)对照组Bcl- 2主要表达于子宫内膜腺上皮细胞胞浆和 /或胞膜。增生期Bcl- 2表达显著高于分泌期 (P <0 0 0 1)。 (2 )子宫内膜异位症组Bcl- 2亦主要表达于子宫内膜腺上皮细胞胞浆和 /或胞膜。增生期Bcl- 2表达显著高于分泌期 (P <0 0 5 )。(3)子宫内膜异位症组与对照组比较 ,其分泌期Bcl- 2表达显著高于对照组 (P <0 0 0 2 )。结论子宫内膜周期性生理变化与Bcl- 2的表达水平改变有关。子宫内膜异位症在位子宫内膜分泌期抗凋亡能力明显增强。推测这种具有抗凋亡活性的子宫内膜细胞逆流至盆腹腔后 ,因其高水平Bcl- 2表达 ,得以逃避机体免疫清除系统的影响而在异位存活、种植。为子宫内膜异位症的发生创造了先决条件。
Objective To detect the expression of endometrial Bcl-2 in endometriosis, and to explore its role in the pathogenesis of endometriosis. Methods The expression of Bcl-2 in endometriosis of 45 cases of pelvic endometriosis and 44 cases of wall-type uterine fibroids was detected by immunohistochemistry (SP method). Results (1) Bcl-2 in the control group was mainly expressed in the cytoplasm and / or membrane of endometrial glandular epithelial cells. The expression of Bcl-2 in proliferative phase was significantly higher than that in secretory phase (P <0.01). (2) Bcl-2 in endometriosis group is also mainly expressed in cytoplasm and / or membrane of endometrial glandular epithelial cells. The expression of Bcl-2 in proliferative phase was significantly higher than that in secretory phase (P <0.05). (3) Compared with the control group, the expression of Bcl-2 in endometriosis group was significantly higher than that in the control group (P <0.002). Conclusion The cyclical physiological changes in endometrium are related to the changes of Bcl-2 expression. Endometriosis in the endometrium secretory phase anti-apoptotic capacity was significantly enhanced. It is speculated that this anti-apoptotic endometrial cells reverse flow to the pelvic cavity, because of its high level of Bcl-2 expression, to escape the impact of the body’s immune clearance system to survive in the ectopic, planting. For the occurrence of endometriosis has created a prerequisite.