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目的探讨基质金属蛋白酶9(MMP-9)及其抑制物TIMP-1在子宫内膜异位症发病中的作用。方法选择2000年9月至2001年9月在南方医科大学珠江医院妇产科确诊为子宫内膜异位症者30例,同期非子宫内膜异位症20例。采用RT-PCR技术检测子宫内膜异位症(内异症)异位和在位内膜及非内异症病人子宫内膜中MMP-9及TIMP-1的表达,凝胶图像光密度分析系统进行PCR产物电泳条带扫描分析。结果异位内膜MMP-9mRNA、MMP-9/TIMP-1比值显著高于在位内膜及非内异症子宫内膜(P<0.01),而TIMP-1mRNA的表达则显著低于后两者(P<0.01)。从美国生育协会修正分期标准(rAFS)Ⅰ~Ⅳ期,异位病灶MMP-9mRNA的表达呈上升趋势,TIMP-1mRNA表达则呈下降趋势。结论异位病灶MMP-9的高水平表达,提示异位内膜组织具有较高的蛋白水解活性,使其具有更强的侵袭能力,易于发生种植转移,可能在子宫内膜异位症的发生发展过程中发挥重要作用。
Objective To investigate the role of matrix metalloproteinase 9 (MMP-9) and its inhibitor TIMP-1 in the pathogenesis of endometriosis. Methods From September 2000 to September 2001, 30 cases of endometriosis were diagnosed in Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University from September 2000 to September 2001, and 20 cases of non-endometriosis in the same period. RT-PCR was used to detect the expression of MMP-9 and TIMP-1 in endometriosis and eutopic and eutopic endometrium of endometriosis patients (endometriosis), and the optical density of gel images System for PCR product electrophoresis band scanning analysis. Results The ratio of MMP-9 mRNA and MMP-9 / TIMP-1 in ectopic endometrium was significantly higher than that in eutopic endometrium and endometriosis (P <0.01), but the expression of TIMP-1 mRNA was significantly lower than that in the latter two (P <0.01). The expression of MMP-9 mRNA in ectopic lesions showed an upward trend and the expression of TIMP-1 mRNA showed a decreasing trend from stage Ⅰ to Ⅳ of the American Society of Reproductive Aid staging (rAFS). Conclusions The high expression of MMP-9 in ectopic lesions suggests that ectopic endometrial tissues have high proteolytic activity, which makes them more invasive and prone to metastasis, which may be involved in the pathogenesis of endometriosis Play an important role in the development process.