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目的:研究尿激酶型纤溶酶原激活物(uPA)及尿激酶型纤溶酶原激活物受体(uPAR)对子宫内膜异位症(简称内异症)发生发展的作用。方法:应用免疫组化方法检测uPA、uPAR蛋白在内异症组(40例)异位内膜、在位内膜中及在对照组(30例)子宫内膜中的表达。结果:①异位内膜、在位内膜、对照组子宫内膜的腺上皮细胞及间质细胞均表达uPA及uPAR蛋白,主要定位于细胞浆;②uPA蛋白在异位内膜表达间质细胞高于腺上皮细胞(P<0.05),uPA蛋白在间质细胞表达异位内膜高于在位内膜及对照组内膜(P<0.05);③uPAR蛋白在异位内膜及对照组内膜表达腺上皮细胞高于间质细胞(P<0.05),uPAR蛋白在腺上皮细胞表达异位内膜高于在位内膜及对照组内膜(P<0.05);④uPA及uPAR蛋白在Ⅰ~Ⅱ期、Ⅲ~Ⅳ期异位内膜表达均高于对照组内膜(P<0.05);⑤异位内膜间质细胞uPA与异位内膜腺上皮细胞uPAR表达呈正相关(P<0.05);⑥uPA及uPAR蛋白在血管内皮呈阳性表达。结论:异位内膜间质细胞uPA蛋白高表达及异位内膜腺上皮细胞uPAR蛋白高表达可能共同促使异位内膜转移、粘附、侵袭、生长,对内异症的发生发展起重要作用。uPA及uPAR对内异症发生发展及临床分期的作用研究对内异症的临床治疗有一定的指导意义。
Objective: To investigate the effects of urokinase-type plasminogen activator (uPA) and urokinase-type plasminogen activator receptor (uPAR) on the development of endometriosis. Methods: The expressions of uPA and uPAR protein in eutopic endometrium, eutopic endometrium and endometrium of endometriosis group (40 cases) were detected by immunohistochemistry. Results: ① The uPA and uPAR proteins were expressed in the eutopic endometrium, eutopic endometrium, and endometrial glandular epithelial cells and the stromal cells of the control group, and mainly located in the cytoplasm. ② The uPA protein expressed in the ectopic endometrial stromal cells (P <0.05). The expression of uPA protein in endometriotic stromal cells was higher than that in eutopic endometrium and control group (P <0.05). The expression of uPAR protein in eutopic endometrium and control group The expression of uPAR in glandular epithelial cells was higher than that in eutopic endometrium and control group (P <0.05); ④ The expression of uPA and uPAR in Ⅰ The expression of uPAR in eutopic endometrial stromal cells and eutopic endometrial glandular epithelial cells was significantly higher than that in control group (P <0.05) 0.05); ⑥uPA and uPAR protein positive expression in the vascular endothelium. CONCLUSION: High expression of uPA in eutopic endometrial stromal cells and high expression of uPAR in ectopic glandular epithelial cells may jointly promote ectopic endometrial metastasis, adhesion, invasion and growth and play an important role in the development of endometriosis effect. UPA and uPAR on the occurrence and development of endometriosis and clinical staging of the study of endometriosis clinical treatment has some guidance.