硫酸基转移酶基因1A3在子宫脱垂主韧带组织中的表达及临床意义

目的 探讨硫酸基转移酶基因1A3(SULT1A3)在子宫脱垂主韧带组织中的表达水平及临床价值。方法选取收治并行手术治疗的53例子宫脱垂（POP-Q分期为Ⅱ～Ⅳ期）患者作为观察组（绝经前18例，绝经后35例），并选取同期无盆腔脏器脱垂和无压力性尿失禁但需行子宫全切术的53例患者作为对照组（绝经前20例，绝经后33例）。均于术中取接近子宫颈的主韧带组织（经病理确认），采用实时荧光定量聚合酶链反应(qRT-PCR)检测各组主韧带组织中SULT1A3、雌激素受体-α(ER-α)和雌激素受体-β(ER-β) mRNA表达水平，并对观察组随访2年，记录其复发情况。结果在观察组和对照组中，与绝经前比较，绝经后主韧带组织中SULT1A3 mRNA水平升高，ER-α mRNA和ER-β mRNA水平降低，差异均有统计学意义（P<0.05）；与对照组比较，观察组主韧带组织中SULT1A3 mRNA水平更高，ER-α mRNA和ER-β mRNA水平更低，差异均有统计学意义（P<0.05）。随访2年，53例子宫脱垂患者中10例复发，其中2例为绝经前，8例为绝经后。与未复发者比较，复发者主韧带组织SULT1A3 mRNA水平相对较高，但ER-α mRNA和ER-β mRNA水平则相对较低，差异均有统计学意义（P<0.05）；在复发者中绝经后主韧带组织SULT1A3 mRNA水平高于绝经前，但其ER-α mRNA和ER-β mRNA水平低于绝经前，差异均有统计学意义（P<0.05）。经Pearson相关分析得知，SULT1A3 mRNA与ER-α mRNA和ER-β mRNA均呈负相关（P<0.05）。结论子宫脱垂患者主韧带组织SULT1A3升高，与ER-α和ER-β下降相关，可能是子宫脱垂发生的重要原因之一。

Expression and clinical significance of sulfatase gene 1A3 in main ligament tissue of patientis with uterine prolapse

Objective To investigate the expression level and clinical value of sulfatase gene 1A3 (SULT1A3) in main ligament tissue of patients with uterine prolapse. Methods Fifty-three patients with uterine prolapse (POP-Q Gtage Ⅱ-Ⅳ) were selected as the experimental group (18 premenopausal, and 35 postmenopausal), and 53 patients without pelvic organ prolapse or stress-free urinary incontinence but received total hysterectomy as the control group (20 premenopausal, and 33 postmenopausal). The expression levels of SULT1A3, estrogen receptor-α(ER-α) and estrogen receptor-β(ER-β) mRNA were assessed by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) in the main ligament tissues. The experimental group was followed up for 2 years. Results In the experimental group and the control group, compared with the premenopausal group, the level of SULT1A3 mRNA in the postmenopausal main ligament tissue was significantly increased, and the levels of ER-α mRNA and ER-β mRNA were significantly reduced (P<0.05). Compared with the control group, the level of SULT1A3 mRNA in the experimental group was significantly higher, and the levels of ER-α mRNA and ER-β mRNA were significantly lower (P<0.05). During the follow-up of 2 years, 10 of 53 cases of uterine prolapse recurred, including 2 premenopausal and 8 postmenopausal cases. Compared with the non-relapsed group, the level of SULT1A3 mRNA in the relapsed group was significantly higher, but the levels of ER-α mRNA and ER-β mRNA were significantly low (P<0.05). In the relapsed group, the level of SULT1A3 mRNA in the main ligament of the postmenopausal group was significantly higher than that of the premenopausal group, but the levels of ER-α mRNA and ER-β mRNA were significantly lower than the premenopausal group (P<0.05). Pearson correlation analysis showed that SULT1A3 mRNA was significantly negatively correlated with ER-α mRNA and ER-β mRNA (P<0.05). Conclusion The increase of SULT1A3 in the main ligament of patients with uterine prolapse is correlated to the down-regulation of ER-α and ER-β, which may be an important reason for the occurrence of uterine prolapse.