米非司酮治疗后VEGF-165在异位和在位子宫内膜中的表达

目的探讨米非司酮对VEGF-165在子宫腺肌症中表达的影响。方法43例子宫腺肌症患者分为对照组(n=21)和米非司酮治疗组(n=22),采用放射免疫法测定对照组(月经第3天)和米非司酮组(术前)血清中FSH、LH、E2、PRL、P及T的水平。采用免疫组化法测定两组患者在在位和异位子宫内膜中的VEGF-165蛋白水平。结果米非司酮组较对照组血清FSH、LH、E2、P明显降低(P<0.05),而血清PRL和T的水平两组间无统计学差异(P>0.05)。VEGF-165在子宫内膜腺上皮细胞内的表达,异位内膜均明显高于在位内膜(P<0.05);而其在间质细胞内的表达,异位内膜与在位内膜无统计学差异(P>0.05)。米非司酮组异位和在位内膜腺上皮细胞、间质细胞中VEGF-165的表达水平均较对照组明显降低(P<0.05)。VEGF-165在对照组异位内膜腺上皮细胞中的表达,增殖期高于分泌期(P<0.05)。结论米非司酮治疗后,VEGF-165在异位和在位内膜中的表达明显下降,可能是通过抑制VEGF蛋白合成,降低血管通透性,抑制新生血管生成,从而有效地控制子宫内膜异位症的发生发展。

Expressions of VEGF-165 in ectopic and eutopic endometrium treated by mifepristone

Objective To explore the expression of VEGF-165 in endometriosis treated by mifepristone. MethodsForty-three patients with endometriosis were divided into two groups: mifepristone group(n=22) and control group(n=21).Serum FSH,LH,E2,PRL,P and T concertration were measured with radiommunoassay at the third day of menses for those in the control group and right before operation for those in the mifepristone group.The expressions of VEGF-165 in eutopic and ectopic endometrium were detected by immunohistochemical techniques. Results The expressions of serum FSH,LH,E2 and P were significantly lower in the mifepristione group than those in the control group(P<0.05),while there was no significant difference in serum PRL and T between the two groups(P>0.05).The expression of VEGF-165 in ectopic endometrial gland was significantly higher than that in eutopic endometrium grand in both groups(P<0.05),while there was no significant difference between ectopic endometrial stroma and eutopic endometrial stroma(P>0.05).The expressions of VEGF-165 in ectopic and the eutopic endometrial gland and stroma were significantly lower in the mifepristione group than those in the control group(P<0.05).In the control group,the expression of VEGF-165 in ectopic endometrial gland was significantly higher in proliferative phase than that in secretory phase of cycle(P<0.05).Conclusion The expressions of VEGF-165 in eutopic and ectopic endometrium may be significantly decreased in the treatment of endometrisis by mifepristone.The synthesis of VEGF protein may be restrained,the vasopermeability be decreased and the angiogenesis be inhibited,all contributing to the control of endometrsis.