靳卫国;李爱华;刘艳军;席焕英;张改英;陈双峰;任玉波;

• 1:聊城市人民医院妇科

摘要(Abstract)：

目的:检测子宫内膜异位症(endometriosis,EM)组织中骨桥蛋白(osteopon-tin,OPN)、血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达,探讨子宫内膜异位症的发病机制,OPN在子宫内膜异位症血浆中的含量以及OPN在子宫内膜异位症诊断及鉴别诊断方面的应用。方法:用免疫组化SP法检测56例子宫内膜异位症患者异位内膜及在位内膜中OPN、VEGF的表达,用酶联免疫吸附方法检测患者术前血浆OPN含量。结果:(1)异位内膜OPN表达主要分布于腺上皮细胞细胞膜,阳性(++⁺++)表达率与在位内膜相似,明显高于对照内膜,差异有显著性(P<0.01),异位内膜细胞大多受挤压萎缩,缺乏典型的周期性改变;(2)VEGF在异位内膜胞浆染色,呈棕色颗粒,表达阳性,其中阳性(+++++)表达率与在位内膜相似,明显高于对照内膜,差异有显著性(P<0.01),异位内膜细胞大多受挤压萎缩,缺乏典型的周期性改变;(2)VEGF在异位内膜胞浆染色,呈棕色颗粒,表达阳性,其中阳性(++⁺++)表达率明显高于在位内膜及对照内膜(P<0.01);(3)异位内膜组织中OPN、VEGF表达有相关性(rs=0.596,P<0.01)。在子宫肌瘤对照内膜组织OPN、VEGF的表达则无相关性(rs=0.153,P=0.507);(4)子宫内膜异位症患者术前血浆OPN均值46.26±8.72ng/m l(15.54+++)表达率明显高于在位内膜及对照内膜(P<0.01);(3)异位内膜组织中OPN、VEGF表达有相关性(rs=0.596,P<0.01)。在子宫肌瘤对照内膜组织OPN、VEGF的表达则无相关性(rs=0.153,P=0.507);(4)子宫内膜异位症患者术前血浆OPN均值46.26±8.72ng/m l(15.54¹39.12ng/m l),高于良性肿瘤及正常对照组(P<0.01),后二者无显著差异。卵巢癌患者术前血浆OPN均值81.32±14.41ng/m l(22.72139.12ng/m l),高于良性肿瘤及正常对照组(P<0.01),后二者无显著差异。卵巢癌患者术前血浆OPN均值81.32±14.41ng/m l(22.72¹97.94ng/ml),较内异症患者水平高(P<0.01)。结论:OPN在异位内膜细胞高表达,可能推动异位内膜黏附和侵袭,OPN、VEGF可能通过促血管生成,共同促进异位内膜种植与生长,在子宫内膜异位症发生发展中起重要作用;OPN在盆腔包块鉴别诊断方面有一定应用价值。

关键词(KeyWords)： 骨桥蛋白;血管内皮生长因子;子宫内膜异位症;免疫组织化学;酶联免疫吸附测定

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 靳卫国;李爱华;刘艳军;席焕英;张改英;陈双峰;任玉波;

DOI: 10.13283/j.cnki.xdfckjz.2008.08.010

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