摘要
目的:测定细胞色素芳香化酶P450(aromatase cytochrom P450,P450arom)在子宫内膜异位症(endometriosis,EMS)患者异位、在位内膜与正常子宫内膜中的表达,探讨P450arom表达水平与EMS的相关性,试图寻求EMS的一种早期辅助筛查方法。
方法:应用免疫组化链霉菌抗生物蛋白-过氧化物酶连接(SP)方法,检测正常子宫内膜(对照组)和EMS(研究组)的在位内膜及异位内膜中P450arom的表达。
结果:研究组30例中29例异位内膜、27例在位内膜组织有P450arom表达,阳性表达率分别为96.7%和90%;对照组内膜仅有1例呈现弱表达,阳性表达率为5%;P450arom在研究组异位内膜中的阳性表达率明显高于对照组内膜,两者有极显著差异(X~2=40.7;P<0.01);P450arom在研究组在位内膜中的阳性表达率亦明显高于对照组内膜,两者有极显著差异(X~2=27.57;P<0.01)。P450arom的阳性表达率在研究组的异位内膜和在位内膜间差异无显著性(X~2=2.71;p>0.05);研究组异位内膜中P450arom表达随rAFS分期的增加而加强(X~2=11.05P<0.05),而在位内膜中P450arom表达不随rAFS分期的增加而加强(X~2=1.95,P>0.05)。在EMSⅠ-Ⅱ期中异位内膜与在位内膜P450arom表达强度差异无统计学意义(X~2=2.26,P>0.05);而Ⅲ-Ⅳ期中异位内膜P450arom表达强度明显高于在位内膜,差异有显著性(X~2=3.86 P<0.05)。本组研究中子宫内膜组织P450arom阳性表达用于诊断子宫内膜异位症敏感度为90%,特异度为95%。
结论:P450arom在EMS患者的在位内膜及异位内膜中存在过度表达,并且异位内膜中的表达与EMS分期呈一定的正相关性。P450arom在正常子宫内膜中不表达或弱表达,因此,P450arom可以作为EMS一种早期辅助筛查方法。
Objective:Detected the expression of aromatase cytochrom P450 in nomal,the eutopic and ectopic endometrium of endometriosis,to study the correlation of the aromatase cytochrom P450 with endometriosis,and to evaluate its clinical value as a diagnostic method for endometriosis.
Methods:Detemine the expression of aromatase cytochrom P450 in nomal,the eutopic and ectopic endometrium of endometriosis by immunohistochemical assay(stretavidin-peroxidade-biotin,SP).
Result:The positive rate of aromatase cytochrom P450 expression in eutopic endometrium and ectopic endometrium from study group was 96.7%(29/30) and90%(27/30),but it was negative or weakly expressed in nomal endometrium,its positive rate expression was 5%(1/20).The positive rate of aromatase cytochrom P450 expression in eutopic endometrium and ectopic endometrium was significantly higher than that in nomal endometrium(X~2=40.7;X~2=27.57;p<0.01);But in study group there was no significant diference between the eutopic endometrium and the ectopic endometrium(X~2=2.71;p>0.05).In EMSⅠ-Ⅱthere was no significant difference of the posistive rate of P450arom between the eutopic endometrium and ectopic endometrium (X~2=2.26,P>0.05);but inⅢ-Ⅳthe expression of P450arom in eutopic endometrium was significant high than that in ectopic endometrium(X~2=3.86 P<0.05).there were correlation between the degree of the P450arom expression in eutopic endometrium with rAFS(X~2=11.05 P<0.05);But in ectopic endometrium there were no such relationship(X~2=1.95,P>0.05).The aromatase cytochrom P450 expression in ectopic endometrium is useful in diagnostic assessment of EMS with sensitivity 90%and specificity 95%.
Conclusions:There were increased expression of the aromatase cytochrom P450 in the eutopic and the ectopic endometrium of endometriosis,which may play an important role in pathogenesis and the development of endometriosis.P450arom can be used as a marker for diagnosis.
引文
[1]郎景和 《子宫内膜异位症研究的任务与展望》 中华妇产科杂志2006,Vol.41:289-290
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[6]Zhao Y,N ichols JE,Bulun SE,et al A romatase P450 gene expression in human adipose tissue:role of a JAK/STAT pathway in regulation of the adipose-specific promoter JB iol Chen,1995,270(2):16449-1645
[7]prefrontaincM,ShihC,PanCC,etal Applicalicability of the product iaolation and radiometric aromatase assays for the measurement of low levels of anomatase:lack of aromatase activity in the human cndomtrium.J Endocrinol. 1990.127;536-551
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