凋亡抑制蛋白Survivin和Ki-67在子宫腺肌病组织中的表达及意义

目的:检测凋亡抑制蛋白Survivin及细胞核相关抗原Ki-67在子宫腺肌病(adenomyosis,AM)组织中的表达,研究以Survivin、Ki-67为核心的细胞凋亡、增殖在子宫腺肌病发病中的作用及相关意义。方法:2004年10月~2006年10月在大连医科大学附属第一医院采用免疫组织化学SP法检测30例子宫腺肌病子宫标本中异位内膜、在位内膜、平滑肌组织及对照组18例正常子宫内膜、平滑肌组织中Survivin蛋白和Ki-67的表达。结果:①腺上皮细胞:Survivin蛋白表达为异位内膜>在位内膜>正常子宫内膜(P=0.017,0.000,0.001,P<0.05);Ki-67表达为异位内膜显著高于在位内膜及正常子宫内膜(P=0.006,0.033,P<0.05),而在位内膜与正常内膜差异无统计学意义(P=0.622,P>0.05)。②间质与平滑肌:Survivin蛋白及Ki-67在3组内膜间质细胞中及病例-对照组平滑肌细胞中表达差异均无统计学意义(P>0.05)。③Survivin蛋白与Ki-67在子宫腺肌病异位内膜腺上皮细胞表达呈正相关性(r=0.367,P=0.046,P<0.05)。结论:Survivin蛋白和Ki-67在AM内膜腺上皮细胞中的过度表达及两者的协同作用可能参与了子宫腺肌病的发病过程,子宫内膜细胞凋亡和细胞增殖失衡可能是子宫腺肌病的发病机理之一。

Expression and signification of anti-apoptosis proteins Survivin and Ki-67 in adenomyoms

Objective:To investigate the expression of anti-apoptosis proteins Survivin and ki-67 in tissue in adenomyosis in order to study the function and relative signification of apoptosis,cell proliferation in the course of adenomyosis.Methods:Patients were random selected from the department of gynecology and obstetrics in the first affiliated hospital of Dalian medical university from October in 2004 to October in 2006.Protein expression levels of Survivin and Ki-67 in ectopic and eutopic endometrial tissues surgically obtained from 30 women with adenomyosis were compared with those in control eutopic endometrium from 18 women without adenomyosis by streptavidin-biotin peroxidase(SP)method of the immunohistochemistry.Those expression was examined in the endometrial glandular and stromal cells at the same time in smooth muscle cells of adenomyosis and control group.Results:①In endometrial gland: the expression of Survivin protein in ectopic endometrium of adenomyosis was significantly higher than that in eutopic endometrial and normal endometrium(P=0.017,0.000,P<0.05);The expression of Ki-67 in ectopic endometrium of adenomyosis was significantly higher than that in eutopic endometrial and normal endometrium(P=0.006,0.033,P<0.05),but there was no significant variation between the latter two groups(P=0.622,P>0.05).②In stroma and smooth muscle cell :the expression of Survivin protein and Ki-67 in stromal cells of three groups above had no significant diffrence(P>0.05).A similar tendency was observed in smooth muscle cells of adenomyosis and control.③There was a positive correlation between Survivin and Ki-67 expression levels in glandular epithelial cells in ectopic endometrium of adenomyosis examined(r=0.367,P=0.046,P<0.05)).Conclusion:The overexpression and synergy of Survivin protein and Ki-67 may take part in the formation of adenomyosis,apoptosis and the imbalance of cell proliferation in endometria might play a pathogenic role in the development of adenomyosis.