复方莪术散对卵巢子宫内膜异位囊肿患者异位、在位内膜组织中p21表达的影响

目的 观察复方莪术散对卵巢子宫内膜异位囊肿（简称巧克力囊肿）患者异位和在位内膜组织中细胞周期调节蛋白p21表达的影响.方法 选择因巧克力囊肿行手术治疗者69例,其中35例（用药组）于术前3个月开始规律服用复方莪术散直至手术当日停药,34例（手术组）术前未经过任何治疗直接手术;选择同期因子宫肌瘤行手术治疗者30例作为对照组.采用免疫组化方法检测用药组和手术组异位、在位内膜及对照组子宫内膜组织中的p21.结果 p21在对照组子宫内膜阳性表达率为56.7％,在手术组异位、在位内膜组织中分别为17.7％、26.5％,在用药组异位、在位内膜组织中分别为40.0％、48.6％;对照组和用药组异位、在位内膜p21表达率均高于手术组异位、在位内膜,P均＜0.05.异位内膜p21阳性表达率在用药组Ⅱ期患者中为50.0％、Ⅲ～Ⅳ期为37.0％,手术组分别为40.0％、13.7％;在位内膜p21阳性表达率在用药组Ⅱ期患者中为75.0％、Ⅲ～Ⅳ期为32.4％,手术组分别为60.0％、24.1％;用药组Ⅱ期患者异位和在位内膜p21阳性表达率均高于手术组,P均＜0.05.结论 巧克力囊肿患者子宫内膜组织中p21表达明显减少,复方莪术散能明显上调p21在Ⅱ期患者子宫内膜组织中的表达.

Effect of compound Rhizoma Curcumae power on expression of p21 in ectopic and eutopic endometria in patients with ovarian endometriosis cyst

Objective To observe the effect of compound Rhizoma Curcumae power on the expression of p21 in ectop- ic and eutopic endometria in patients with ovarian endometriosis cyst （ chocolate cyst）. Methods A total of 69 patients with chocolate cyst were included, who had undertaken surgical treatment and improved pathologically. Among them, 35 cases （ treatment group） were regularly administrated with compound Rhizome Curcumae power for 3 months before surgery, 34 cases （ operation group） undertook surgery operation without any treatment of integrative Chinese and Western medicine. Another 30 cases （control group） with uterine myoma were improved pathologically, who had undertaken surgical operation in the same duration. The immunohistochemistry method was used to detect the expression of p21 in eetopic and eutopie en- dometria in patients with chocolate cyst and uterine myoma. Results The positive expression rate of p21 was 56.7% in the control group, 17.7% and 26.5% in ectopic and eutopic endometria of the surgery group, and 40.0% and 48.6% in ectopic and eutopic endometria of the treatment group. The expression rates of p21 in the control group and in ectopic and entopic endometria of the treatment group were significantly higher than those in the surgery group （ all P 〈 0.05 ） ： In ec- topic endometrium, the positive expression rate of 1021 was 50.0% in patients in Ⅱ period and 37.0% in Ⅲ -Ⅳ period in the treatment group; the expression rate was 40.0% in patients in Ⅱ period and 13.7% in Ill-IV period in the surgery group. In eutopic endometrium, the positive expression rate of p21 was 75.0% in patients in Ⅱ period and 32.4% inⅢ -Ⅳ period in the treatment group; the expression rate was 60.0% in patients in Ⅱ period and 24.1% in Ⅲ -Ⅳ period in the surgery group. The positive expression rate of p21 in Ⅱ period was higher in the treatment group than in the surgery group（ all P 〈 0.05）. Conclusions The expression of p21 in patients with chocolate cyst is significantly decreased. The com- pound Rhizoma Curcumae power can apparently up-regulate the expression of p21 in the endometria of patients with endo- metriosis in Ⅱ period.