背景目前子宫内膜异位症的治疗方法仍比较有限，而米非司酮在临床上可用于治疗子宫内膜异位症，但其具体机制尚未明确。目的探讨米非司酮对子宫内膜异位症子宫内膜腺上皮细胞中骨桥蛋白（OPN）、基质金属蛋白酶9（MMP -9）表达的影响。方法选取2014年8月—2015年3月宁夏医科大学总医院妇科因卵巢巧克力囊肿行卵巢囊肿剥除术或患侧附件切除术的子宫内膜异位症患者21例为研究对象。按照术前是否接受米非司酮治疗将其分为米非司酮组（11例）和对照组（10例）。获取所有患者在位、异位内膜组织，采用免疫组化法检测其中 OPN、MMP -9表达水平；取对照组患者在位子宫内膜组织，培养子宫内膜腺上皮细胞，以不同剂量（0、0.1、1.0、10.0 mmol/ L）米非司酮进行干预，采用反转录-聚合酶链式反应（ RT - PCR）法检测子宫内膜腺上皮细胞中 OPN、MMP -9表达水平。结果米非司酮组在位、异位内膜组织中 OPN、MMP -9表达水平均低于对照组（P ﹤0.05）。0.1 mmol/ L、1.0 mmol/ L 米非司酮干预子宫内膜腺上皮细胞中 OPN、MMP -9 mRNA 表达水平低于0 mmol/ L（P ﹤0.05）；1.0 mmol/ L、10.0 mmol/ L 米非司酮干预子宫内膜腺上皮细胞中 OPN、MMP -9 mRNA 表达水平高于0.1 mmol/ L（P ﹤0.05）；10.0 mmol/ L 米非司酮干预子宫内膜腺上皮细胞中 OPN、MMP -9 mRNA 表达水平高于1.0 mmol/ L（ P ﹤0.05）。结论米非司酮可明显下调子宫内膜异位症子宫内膜中 OPN、MMP -9表达水平，从而抑制子宫内膜的侵袭、黏附以及种植性转移。%Background The therapeutic method towards endometriosis is still in limitation,and mifepristone can be used to treat endometriosis in clinic,but its specific mechanism still remains unclear. Objective To investigate the influence of miferpristone on the expression of osteopontin(OPN)and matrix metalloproteinase 9(MMP - 9)in the endometrium epithelial cells of patients with endometriosis. Methods 21 patients with endometriosis,who suffered ovarian cyst enucleation or adnexectomy due to ovarian chocolate cyst in Department of Gynecology in General Hospital of Ningxia Medical University from August 2014 to March 2015,were recruited in the study. They were divided into mifepristone group(11 cases)and control group (10 cases)based on whether they had undergone mifepristone therapy. The eutopic and ectopic endometrium of all these patients were obtained through surgery,and immunohistochemistry method was used to detect the expression level of OPN and MMP - 9;the culture of endometrium epithelial cells in the eutopic endometrium of patients in control group were performed with the intervention of different doses of mifepristone(0,0. 1,1. 0,10. 0 mmol/ L),and inverse transcription - polymerase chain reaction(RT - PCR)method was used to investigate the expression level of OPN and MMP - 9 in the endometrial epithelial cells. Results The expression levels of OPN and MMP - 9 in mifepristone group both in eutopic and ectopic endometrium were lower than those in control group(P ﹤ 0. 05). The mRNA expression levels of OPN and MMP - 9 in endometrium epithelial cells after the intervention of mifepristone at a dose of 0. 1 and 1. 0 mmol/ L were lower than those at 0 mmol/ L( P ﹤ 0. 05);the mRNA expression levels of OPN and MMP - 9 in endometrium epithelial cells after the intervention of mifepristone at a dose of 1. 0 and 10. 0 mmol/ L were higher than those at 0. 1 mmol/ L( P ﹤ 0. 05);the mRNA expression levels of OPN and MMP - 9 in endometrium epithelial cells after the intervention of mifepristone at the dose of 10. 0 mmol/ L were higher than those at 1. 0 mmol/L(P ﹤ 0. 05). Conclusion Mifepristone can obviously lower the expression levels of OPN and MMP - 9 in endometrium of endometriosis,and thus inhibit the invasion,adhesion and implantation metastasis of endometrium.
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