基质金属蛋白酶-9及其组织抑制剂TIMP-3在子宫内膜异位症的表达

目的 :探讨基质金属蛋白酶 9(MMP 9)及其抑制剂TIMP 3在子宫内膜异位症发生发展中的作用。方法 :采用免疫组化链霉菌抗生物素蛋白 过氧化物酶染色法 (SP法 )检测 4 3例子宫内膜异位症的异位内膜和在位内膜中MMP 9、TIMP 3的表达 ,以 19例正常子宫内膜为对照组 ,并用银染法观察腺上皮基底膜的完整性。结果 :在异位内膜组织的腺上皮细胞MMP 9呈高表达状态 ,与子宫内膜异位症在位内膜和正常子宫内膜相比 ,差异有高度显著性 (P <0 .0 1)。子宫内膜异位症的在位内膜和异位内膜TIMP 3均呈低表达 ,与正常内膜相比 ,差异有高度显著性 (P <0 .0 1) ,异位内膜较在位内膜TIMP 3的表达降低 ,差异有显著性 (P <0 .0 5 )。子宫内膜腺上皮的基底膜银染结果显示 :MMP 9与TIMP 3的染色强度比值与基底膜的阳性率呈负相关 (P <0 .0 1)。MMP 9、TIMP 3的表达强度与子宫内膜异位症的严重程度无显著相关性。结论 :异位内膜组织中MMP 9过度表达 ,而TIMP 3的表达下降 ,导致MMP 9/TIMP 3的比例增高 ,使子宫内膜异位症患者的异位内膜更具侵袭性 ,在子宫内膜异位症的发生发展中起重要作用

The expression of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-3 in endometriosis

Objective:To investigate the role of matrix metalloproteinase-9 (MMP-9 )and tissue inhibitor of metalloproteinase-3 (TIMP-3) in the pathogenesis of endometriosis.Methods:Immunohistochemical method (S-P) was employed to detect the expression of MMP-9 and TIMP-3 in ectopic endometriotic tissue and eutopic endometrium from women with endometriosis (43 cases) and the normal controls(19 cases).Silver impregnation was used to investigate the integrity of the basement membrane under the glands.Results:The expression of MMP-9 in glandular cells was significantly higher than those of uterine endometrium from women with and without endometrosis(P< 0.01).The expression of TIMP-3 in the eutopic and ectopic endometrium of the patients with endometrosis was lower than that in the normal endometrium (P<0.01).And the expression of TIMP-3 in the ectopic tissues was even lower than that of the eutopic endometrium from women with endometriosis(P<0.05).Silver impregnation showed the ratio of MMP-9/TIMP-3 was related inversely to the integrity of the basement membrane in gland in the eutopic and ectopic endometrium (P<0.01).Conclusions:The increased expression of MMP-9 and the decreased expression of TIMP-3 in the ectopic endometriotic tissues result in the higher ratio of MMP-9/TIMP-3,which contributes to the pathogenosis of endometriosis.