子宫腺肌病异位内膜细胞的凋亡及其调控蛋白Bcl-2表达的研究

目的研究子宫腺肌病在位和异位内膜腺体和间质细胞凋亡及Bcl-2的调控作用。方法子宫腺肌病（简称腺肌病）27例,对照组（肌瘤组）32例。应用免疫组化方法检测在位和异位内膜腺体和间质细胞Bcl-2的表达;采用脱氧核糖核苷酸末断转移酶介导的缺口末端标记（TUNEL）技术测定子宫内膜细胞的凋亡数（凋亡细胞数/10个高倍视野）。结果腺肌病组异位内膜腺体和间质细胞的凋亡数较其在位内膜均显著降低（腺体细胞P〈0.001,间质细胞P=0.001）。两组在位内膜腺体和间质细胞中Bcl-2表达均呈周期性变化,其染色强度增生期均显著高于分泌期（P〈0.05）。腺肌病组异位腺体和间质细胞中Bcl-2染色强度均高于其同期在位内膜,（P=0.035,P=0.016）。腺肌病组内膜细胞凋亡数与Bcl-2表达呈负相关。结论与在位内膜相比,腺肌病患者异位内膜细胞凋亡显著减少。Bcl-2可能是抑制腺肌病内膜细胞凋亡的重要因素之一。

Study of cell apoptosis and Bcl-2 expressions in the ectopic nidus of adenomyosis

Objective To investigate the role of apoptosis and Bcl-2in the eutopic and ectopic endometrium of adenomyosis.Methods 27patients with histologically proven adenomyosis and 32patients with leiomyoma of the uterus were included in this study.Immunohistochemical staining was used to detect Bcl-2expression in eutopic and ectopic endometrium from women with adenomyosis and eutopic endometrium from women with leiomyoma.Apoptosis was detected with by dUTP nick-end labeling (TUNEL) in the eutopic and ectopic endometrium.Results The apoptosis index decreased significantly in the glandular cells and stromal cells of ectopic endometrium compared to that of eutopic endometrium (P<0.001 , P=0.001) .The Bcl-2staining intensity in glandular and stromal cells in ectopic endometrium increased in proliferative phase compared to luteal phase (P<0.05) .The Bcl-2staining intensity of glandular and stromal cells in ectopic endometrium was stronger compared with that of in eutopic endometrium (P=0.035 , P=0.016) .Significant negative correlation was found between apoptosis index and the Bcl-2staining intensity in adenomyosis.Conclusion Apoptosis index of ectopic endometrium decreased markly in adenomyosis , Bcl-2was likely to be one of the important apoptosis inhibitors in ectopic endometrium of adenomyosis.