子宫内膜异位症中Livin和Smac的表达及相关性研究

目的探讨凋亡抑制蛋白家族的新成员Livin、第2个线粒体来源的胱氨酸蛋白酶激活剂Smac在子宫内膜异位症(EMs)中的表达及二者与月经周期、EMs临床分期的关系和相关性分析。方法选取2010年10月至2012年4月在内蒙古医学院第三附属医院妇产科病房因EMs接受腹腔镜手术或开腹手术,并且具有术后病理确诊的EMs患者共60例作为研究组,收集子宫内膜异位症病患的在位内膜、异位内膜组织各30例(增生期各16例,分泌期各14例),对照组为30例正常内膜组织。采用免疫组化SP法检测出各组标本中Livin、Smac蛋白的表达,并对结果进行统计分析。结果 EMs在位、异位内膜组织中Livin的表达强度较对照组显著升高,差异有统计学意义(x^2=12.510,P<0.05);EMs在位、异位内膜组织中Smac的表达强度均低于正常子宫内膜的表达,差异有统计学意义(x^2=19.530,P<0.05)。在EMs在位内膜和异位内膜组织中,Livin和Smac的表达均与临床分期无关(x^2值分别为0.741、0.002,均P>0.05);在EMs在位内膜和异位内膜组织中,Livin和Smac的表达呈负相关(r_s值分别为-0.933、-0.867,均P<0.05)。结论 Livin高表达以及Smac低表达使异位内膜细胞增生及抗凋亡能力加强,导致了EMs的发生及发展。

Expressions of Livin and Smac and their correlation in endometriosis

Objective To explore the expressions of new member of apoptosis inhibiting protein family Livin and second mitochondrial activator of caspase (Smac) in EMs and and analyze the relationship between their expressions and menstrual cycle as well as EMs clinical staging.Methods In the Third Affilated Hospital of Inner Mongolia Medical College, 60 cases of EMs confirmed by pathological results after lapascopic surgery or abdominal surgery were selected in study group.Thirty samples of ectopic endometrium and eutopic endometrium of EMs (16 samples in proliferative phases and 14 samples in secretive phases) were collected in study group and another 30 samples of normal endometrium tissues were collected in control group.The method of immunohistochemistry was used to determine the expressions of Livin and Smac proteins.All statistical analyses were carried out with SPSS16.0 software.Results The expressions of Livin in ectopic endometrium and eutopic endometrium of EMs group were significantly higher than in the control group with statistical significance (χ2 =12.510, P<0.05).But the expressions of Smac in ectopic endometrium and eutopic endometrium of EMs group were significantly lower than in the control group with statistical significance (χ2 =19.530,P<0.05).Both in ectopic endometrium and eutopic endometrium of EMs group and the control group, the expressions of Livin and Smac were not correlated with clinical staging (χ2 value was 0.741 and 0.002, respectively, both P>0.05).In study group the expression of Livin was negatively correlated with that of Smac both in ectopic endometrium and eutopic endometrium of EMs (rs value was -0.933 and -0.867, respectively, both P<0.05).Conclusion The high expression of Livin and low expression of Smac strengthen the ability of hyperplasia of endometrial cells and antiapoptotic capacity, which leads to the occurrence and development of EMs.