VEGF和PTEN蛋白在子宫内膜异位症中表达及临床意义

目的 研究血管内皮生长因子（VEGF）和磷酸酶基因（PTEN）蛋白在子宫内膜异位症（EMs）中的表达及其调节,从血管形成和基因调控方面进一步探究它们在EMs发生、发展中的作用和意义.方法 取EMs异位内膜58例,EMs在位内膜25例,正常子宫内膜20例,应用免疫组化二步法对VEGF和PTEN蛋白的表达进行研究,结合病例的治疗、复发及受孕情况进行分析.结果 VEGF在EMs患者的异位内膜中表达高于在位和正常内膜中的表达率（P＜0.05）,但PTEN在EMs患者的异位、在位内膜均低于正常内膜中的表达（均P＜0.05）;VEGF在EMs在位和异位内膜中的增生期与分泌期中的表达比较差异有统计学意义（P＜0.05）,但正常内膜中差异无统计学意义（P ＞0.05）;而PTEN在EMs患者在位、异位和正常内膜中的增生期和分泌期中的表达差异无统计学意义（P ＞0.05）.在VEGF和PTEN 蛋白表达与患者的年龄、痛经情况、囊肿大小及术后受孕与否均关系不密切,但与临床分期和术后复发密切相关;VEGF和PTEN蛋白表达呈负相关（P＜0.05）.结论 VEGF直接参与EMs的血管生成,PTEN蛋白在EMs中表达存在缺失或减弱,从而上调VEGF的表达.它们可能参与EMs的血管生成,促进异位内膜细胞的种植和病情发展.

Expression of VEGF and PTEN in endometriosis and its clinical significance

Objective To investigate the expression of vascular endothelial growth factor（VEGF） and phosphatase and tensin homology deleted on chromosome ten （PTEN） in endometriosis and its clinical significance. Methods The expression of VEGF and PTEN was detected with immunohistochemistry technique in 58 specimens of ectopic endometrium, 25 specimens of eutopic endometrium from patients with entometriosis, and 20 specimens of normal endometrium. Results The positive rates of VEGF in ectopic endometrium and eutopic endometrium were higher than that in normal endometrium; the expression of VEGF was significantly higher in secretary phase than that in proliferative phase of ectopic and eutopic endometrium （P 〈0.05）, but not in normal endometrium. The expression of PTEN was lower in ectopic endometrium and eutopic endometrium than that in normal endometrium, and there was no significantly difference between secretary and proliferative phase. The expression of VEGF and PTEN was corrected with clinical staging and postoperative recurrence （P 〈0.05）, but not with age, dysmenorrhea, cyst diameter, pregnancy in endometriosis patients. There was a negative correlation between VEGF and PTEN （P 〈0.05）. Conclusion VEGF and PTEN might be involved in the implantation and development of endometriosis.