细胞核增殖抗原ki-67在异位和在位子宫内膜中的表达

目的 通过观察细胞核增殖抗原ki-67在子宫内膜异位症中的表达探讨子宫内膜细胞增殖能力对子宫内膜异位症发病的影响。方法 应用免疫组化SP法检测58例子宫内膜异位症(EMS)患者(包括36例卵巢子宫内膜异位症和22例子宫腺肌症)的异位内膜和在位内膜及15例子宫肌瘤患者子宫内膜(对照组)中ki-67的表达情况，以增殖指数为统计指标。结果 卵巢EMS组和子宫腺肌症的在位和异位内膜ki-67的表达差异均无显著性；对照组子宫内膜和EMS组在位内膜的腺体和间质的ki-67表达在增生期均显著高于分泌期，EMS异位内膜增殖指数在增生期和分泌期差异无显著性 (P>0.05)；EMS异位内膜ki-67增殖指数在增殖期低于在位内膜，但在分泌期则显著高于在位内膜(P<0.01)；EMS异位内膜腺体Ⅰ~Ⅱ期时的ki-67表达高于Ⅲ、Ⅳ期，但在位内膜的ki-67表达在不同临床分期中差异无显著性 (P>0.05)。结论 ki-67增殖指数反映了子宫内膜细胞的增殖活性，EMS异位内膜细胞持续增殖活跃可能在子宫内膜异位症发生发展中起重要作用。

Expression and Significance of ki-67 in Endometriosis

Abstract] Objective To detect the expression of proliferating cell nuclear antigen(ki-67) in endometriosis(EMS), so as to investigate the pathogenesis of endometriosis．Methods Immunohistochemical SP stain methods was used to examine the expression of ki-67 in the eutopic and ectopic endometrium of 58 cases of endometriosis(EMS group), as well as endometrium of 15 cases of hysteromyoma(control group). Proliferation index(PI) was counted. Results PI of ovarian EMS showed no difference with that of adenomyosis. PIs of glandular epithelium and stromal cells in control group endometrium and EMS group eutopic endometrium in proliferative phase were all higher than that in secretory phase. PI of ectopic endometrium in proliferative phase showed no difference with that in secretory phase(P>0.05). PI of ectopic endometrium was lower than that of eutopic endometrium in proliferative phase, but higher than eutopic endometrium in secretory phase(P<0.01). PI of ectopic endometrium glandular epithelium in Ⅰ~Ⅱ stage was higher than that in Ⅲ,Ⅳ stage(P<0.05). But PI of eutopic endometrium showed no difference in different r-AFS stages(P>0.05). Conclusions The proliferative activity of ectopic endometrium was stronger than that of eutopic endometrium in secretory phase. The continuous high proliferative activity of the endometrium may play an important role on the development of endometriosis.