子宫内膜息肉细胞凋亡及增殖的研究

 目的　从细胞凋亡与增殖方面探讨子宫内膜息肉的发病机制，解释其临床症状。方法　免疫组织化学方法与计算机图像分析系统定量检测bcl-2、Bax、Ki-67表达，计算Bax／bcl-2 比值。对比分析增殖期息肉（40例）与增殖期内膜（40例）之间、分泌期息肉（40例）与分泌期内膜（40例）之间表达情况，腺上皮与间质分别对照。结果　Ki-67在不论是增殖期还是分泌期腺上皮细胞中，息肉组显著高于对照内膜组（P＜0.01），而在间质中息肉组低于对照内膜组（P＝0.000）。Bax在增殖期息肉腺上皮的表达高于增殖期内膜腺上皮。bcl-2在分泌期息肉与分泌期内膜之间不论是腺上皮还是间质，均是前者高于后者。不管是分泌期还是增殖期，间质Bax／bcl-2在息肉组显著低于内膜组。结论　子宫内膜息肉的发生可能与腺上皮细胞过度增生及间质细胞凋亡受限有关。息肉增殖、凋亡及脱落与周围内膜不同步，且息肉内部本身增殖、凋亡不同步，两个不同步导致不规则、经间期出血的临床表现。

A study on the expression of apoptosis and proliferation in endometrial polyps

Objective To investigate the pathogenesis of endometrial polyps.Methods We studied specimens including 40 proliferative phase endometrial samples,40 proliferative phase endometrial polyps,40 secretory phase endometrial samples and 40 secretory phase endometrial polyps.Immunohistochemical method was employed to detect the expression of bcl-2,Bax,Ki-67 and the ratio of Bax to bcl-2 was colculated.Contrast analysis was made between proliferative phase endometrial polyps and proliferative phase endometrium,secretory phase endometrial polyps and secretory phase endometrium.The expression in glandular epithelium and stroma was analyzed individually.Results In glandular epithelium,either in proliferative phase or in secretory phase,Ki-67 expression in endometrial polyps was higher than that in endometrium(P<0.01),but in stroma,the former was lower than the latter(P<0.01).In glandular epithelium,the expression of Bax in proliferative phase endometrial polyps was higher than that in proliferative phase endometrial samples (P<0.01). Expression of bcl-2 in secretory phase endometrial polyps was higher than that in secretory phase endometrium(P<0.05).In stroma,either in proliferative phase or in secretory phase,the ratio of Bax to bcl-2in endometrial polyps was lower than that in normal endometrium. Conclusion Endometrial polyps pathogenesis is related with glandular epithelial hyperplasia or stromal limited apoptosis.