子宫内膜异位症患者在位子宫内膜Fas、FasL的表达及其意义

目的检测子宫内膜异位症患者在位子宫内膜Fas及其配体(FasL)的表达,探讨其在子宫内膜异位症发生机制中的作用.方法采用免疫组织化学法(SP法)对45例盆腔子宫内膜异位症和44例壁间型子宫肌瘤患者在位子宫内膜进行Fas、FasL表达检测.结果(1)对照组Fas、FasL主要表达于子宫内膜腺上皮细胞胞浆和/或胞膜.增生期Fas、FasL表达显著低于分泌期(P＜0.05).(2)子宫内膜异位症组Fas、FasL亦主要表达于子宫内膜腺上皮细胞胞浆和/或胞膜.增生期与分泌期Fas、FasL表达差异无显著意义.(3)与对照组比较,子宫内膜异位症组分泌期Fas、FasL表达显著低于对照组(P＜0.05).结论子宫内膜周期性生理变化与Fas及其配体的表达水平改变有关.子宫内膜异位症在位子宫内膜分泌期凋亡敏感性降低.推测这种具有抗凋亡活性的子宫内膜细胞逆流至盆腹腔后,因其Fas低水平表达,得以逃避机体免疫清除系统的影响而在异位存活、种植,为子宫内膜异位症的发生创造了先决条件.

Expression and significance of Fas, FasL in patients with Endometriosis

Objective To evaluate the function of FAS, FasL in the etiology or pathogenesis of endometriosis. Methods immunohistochemistry method was used to detect the expression of Fas, FasL protein in the patients with endometriosis (45 cases) and intramural myoma of uterus (44 cases). Results 1. In control group: the expression of Fas, FasL predominated in the glandular cytoplasm and/or on the plasma membrane. Both Fas and FasL expression in proliferative phase were lower than those in secretory phase significantly ( P <0.05).2. In endometriosis group: Fas, FasL expression also predominated in the glandular cytoplasm and/or on the plasma membrane. There were no differences between proliferative and secretory phase in either Fas or FasL expression. 3. Both fas and FasL expressions in secretory phase the endometriosis group were lower significantly than those in control group ( P <0.05). Conclusion The cyclic changes of eutopic endometrium was related to Fas, FasL expressions. The patients with endometriosis have a significant reduction in their apoptotic susceptibility in secretory phase endometrium. It is suggested that the retrograding of these active ant apoptotic endometrial cells may play a key role in the pathogenesis of endometriosis.