【作者】 张妤；

【导师】 高英敏；

【作者基本信息】 兰州大学 ， 妇产科学， 2008， 硕士

【摘要】 目的:探讨凋亡抑制基因Survivin和血管内皮生长因子(VEGF)在子宫内膜异位症的表达,及两者的相关性,研究Survivin和血管内皮生长因子(VEGF)在子宫内膜异位症的发生、发展中所起的作用。方法:收集子宫内膜异位症标本58例(EM组),其中紫蓝色结节18例,卵巢巧克力囊肿40例,增生期35例,分泌期23例,Ⅰ、Ⅱ期26例,Ⅲ、Ⅳ期32例,取内症患者在位内膜45例,其中增生期26例,分泌期19例。同期取因子宫肌瘤行子宫切除术的正常在位子宫内膜(对照组),共31例,其中增生期18例,分泌期13例。应用免疫组织化学链霉菌抗生物素蛋白—过氧化酶连接法(S-P法),检测Survivin蛋白在EM组和对照组中的表达,同时检测VEGF在EM组和对照组中的表达。实验数据采用SPSS10.0统计软件包进行χ~2检验、相关性分析。规定P＜0.05有统计学意义,P＜0.001有极显著差别。结果:1.Survivin的表达:Survivin在正常子宫内膜、子宫内膜异位症在位子宫内膜、子宫内膜异位症异位子宫内膜中的阳性表达率分别为0%(0/31)、11.1%(5/45)、43.1%(25/58)。在三种不同取材部位的子宫内膜组织中Survivin的阳性表达率有极显著差别(P=0.000＜0.001),在三种不同取材部位的子宫内膜组织中Survivin的表达与月经周期无关(P＞0.05)。2.VEGF的表达:VEGF正常子宫内膜、子宫内膜异位症在位子宫内膜、子宫内膜异位症异位子宫内膜中的阳性表达率分别为45.2%(14/31)、53.3%(24/45)、74.1%(43/58),在三种不同取材部位的子宫内膜组织中VEGF的阳性表达率有极显著差别(P=0.000＜0.001),在三种不同取材部位的子宫内膜组织中VEGF的表达均与月经周期有关,且分泌期高于增生期,差异有显著性(P均＜0.05)。3.Survivin与VEGF在子宫内膜异位症中的相关性:Survivin在子宫内膜异位症中的表达与VEGF的表达密切相关,结果有统计学意义(P＜0.05)。4.Survivin和VEGF在子宫内膜异位症两种不同活性异位病灶中的表达:survivin和VEGF在卵巢巧克力囊肿中的表达分别较两者在紫蓝色结节中的表达增强,差异有显著性(P均＜0.05),提示Survivin和VEGF的表达与子宫内膜异位症异位灶的活性相关。5.Survivin和VEGF在子宫内膜异位症中的表达与子宫内膜异位症临床分期之间的关系:两者的表达与子宫内膜异位症的严重程度无明显相关性(P＞0.05)。结论:1.Survivin蛋白在子宫内膜异位症的异位内膜和在位内膜组织中均异常表达,但缺乏周期性变化。提示Survivin蛋白对子宫内膜异位症的发生、发展起着重要作用。2.VEGF在子宫内膜异位症的异位内膜和在位内膜组织中均异常表达,且存在周期性变化(分泌期高于增生期)。提示VEGF对子宫内膜异位症的发生、发展起着重要作用。3.Survivin蛋白的表达与VEGF在子宮内膜异位症组织中的表达有密切相关性。Survivin蛋白通过抑制异位内膜细胞凋亡,在子宫内膜异位症的发生、发展中起作用;VEGF则通过增加异位内膜组织的血流灌注、促进异位内膜生长和协同抑制内膜细胞凋亡,对子宫内膜异位症的发生、发展起作用。Survivin与VEGF在子宫内膜异位症的发生、发展中相互协同,两者共同作用引起子宫内膜异位症。更多还原

【Abstract】 Objective:To study the expression of Survivin and its relationship with the VEGF in angiogenesis of endometriosis.Methods:A total of 134 tissues samples were used in this study,including 58 samples of ectopic endometrium and 45 samples of eutopic endometriums of patients with endometriosis,and 31 samples of normal endometrium tissues,using streptavidin-biotin peroxidase(SP)method of the immunohistochemistry,we examined the expression of the proteins Survivin and VEGF in these tissues.Statistical analysis was performed by using SPSS10.0 statistics software.Result:1.Survivin were detected in 0/31 normal endometriums,5/45(11.1%)eutopic endometriums and 25/58(43.1%)ectopic endometrium tissues of endometriosis,the expression of Survivin in three group above has significant difference(P=0.000).2.VEGF were detected in 14/31(45.2%)normal endometriums,24/45(53.3%)eutopic endometriums and 43/58(74.1%)ectopic endometrium tissues of endometriosis,the expression of VEGF in three group above has significant difference(P=0.000).3.Survivin was strongly associated with the expression of VEGF(P＜0.05).4.The expression of Survivin and VEGF was related to the activity of endometriotic tissues (P＜0.05).5.There was no obvious correlation between the stage of endometriosis and their expression level(P＞0.05).Conclusions:1.Survivin expression could be observed in both ectopic and eutopic endometrium from patients with endometriosis and was lack of cyclic changes.So it means Survivin gene may play an important roles in the development of endometriosis. 2.VEGF expression also could be observed in both ectopic and eutopic endometrium from patients with endometriosis and it was related to cyclic changes.So it means VEGF may play an important roles in the development of endometriosis,too.3.The expression of Survivin was strongly associated with VEGF.Survivin gene stimulates the development of endometriosis by restraining the apoptosis.However,VEGF stimulates the development of endometriosis by increasing angiogenesis.Both of them may accelerate the endometriosis together.更多还原