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(15.54~139.12ng/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(22.72~197.94ng/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(Author): 靳卫国;李爱华;刘艳军;席焕英;张改英;陈双峰;任玉波;

Email:

DOI: 10.13283/j.cnki.xdfckjz.2008.08.010

参考文献(References)：

• [1]Kim JH,Skates SJ,Uede T,et al.Osteopontin as a poten-tial diagnostic biomarker for ovarian cancer[J].JAMA,2002,287:1671-1679
• [2]朱耀魁,屈洋,夏明翰,等.骨桥蛋白在子宫颈癌及子宫内膜癌组织的表达[J].中国病理生理杂志,2005,21:2414-2417
• [3]Matsuzaki S,Canis M,Darcha C,et al.Angiogenesis in en-dometriosis[J].Gynecol Obstet Invest,1998,46:111-115
• [4]Rittling SR,Chambers AF.Role of osteopontin in tumourprogression[J].Br J Cancer,2004,90:1877-1881
• [5]Johnson GA,Burghardt RC,Joyce MM,et al.Osteopontinis synthesized by uterine glands and a 45-kDa cleavagefragment is localized at the uterine-placental interfacethroughout ovine pregnancy[J].Biol Reprol,2003,69:92-98
• [6]von Wolff M,Strowitzki T,Becker V,et al.Endometrial os-teopontin,a ligand of beta3-integrin,is maximally ex-pressed around the time of the"implantation window"[J].Fertil Steril,2001,76:775-781
• [7]Wai PY,Kuo PC.The role of Osteopontin in tumor metas-tasis[J].J Surg Res,2004,121:228-241
• [8]陈辉,张忠福,方素云.子宫内膜异位症雌、孕激素受体的表达[J].辽宁医学杂志,2001,3:125-126
• [9]Bulun SE,Cheng YH,Yin P,et al.Progesterone resistancein endometriosis:link to failure to metabolize estradiol[J].Mol Cell Endocrinol,2006,248:94-103
• [10]朱耀魁,夏明翰,王晓玉,等.骨桥蛋白在子宫内膜异位症患者异位和在位内膜中的表达[J].中华妇产科杂志,2006,4l:343-344
• [11]Shijubo N,Uede T,Kon S,et al.Vascular endothelialgrowth factor and osteopontin in tumor biology[J].CritRev Oncog,2000,11:135-146
• [12]Senger DR,Ledbetter SR,Claffey KP,et al.Stimulationof endothelial cell migration by vascular permeabilityfactor/vascular endothelial growth factor through cooper-ative mechanisms involving the alphavbeta3 integrin,os-teopontin,and thrombin[J].Am J Pathol,1996,149:293-305
• [13]Tuck AB,Chambers AF.The role of osteopontin in breastcancer:clinical and experimental studies[J].J Mamma-ry Gland Biol Neoplasia,2001,6:419-429
• [14]Hirama M,Takahashi F,Takahashi K,et al.Osteopontinoverproduced by tumor cells acts as a potent angiogenicfactor contributing to tumor growth[J].Cancer Lett,2003,198:107-117
• [15]Pan HW,Ou YH,Peng SY,et al.Overexpression of os-teopontin is associated with intrahepatic metastasis,earlyrecurrence,and poorer prognosis of surgically resectedhepatocellular carcinoma[J].Cancer,2003,98:119-127
• [16]Singhal H,Bautista DS,Tonkin KS,et al.Elevated plas-ma osteopontin in metastatic breast cancer associatedwith increased tumor burden and decreased survival[J].Clin Cancer Res,1997,3:605-611
• [17]Nakae M,Iwamoto I,Fujino T,et al.Preoperative plasmaosteopontin level as a biomarker complementary to carbo-hydrate antigen 125 in predicting ovarian cancer[J].JObstet Gynaecol Res,2006,32:309-314
• [18]Schorge JO,Drake RD,Lee H,et al.Osteopontin as anadjunct to CA125 in detecting recurrent ovarian cancer[J].Clin Cancer Res,2004,10:3474-3478