探讨成纤维细胞生长因子1及成纤维细胞生长因子受体4在卵巢子宫内膜异位囊肿发病中的作用

摘要

目的：探讨成纤维细胞生长因子（FGF）1及FGF受体4（FGFR4）在卵巢子宫内膜异位囊肿发病机制中的作用。方法选择2012年6月至2013年11月在哈尔滨医科大学附属第一医院妇科腔镜病房因卵巢巧克力囊肿（卵巧囊）手术的32例患者为研究组，同期因子宫肌瘤或卵巢畸胎瘤手术的30例患者为对照组。采用免疫组化的方法检测研究组在位内膜及异位内膜和对照组的子宫内膜FGF1和FGFR4的表达情况。结果（1）FGF1在卵巧囊的在位内膜组、异位内膜组及对照组的阳性表达率分别为37.5%、53.1%、23.3%，三组间差异不具有统计学意义。经两两比较，卵巧囊的异位内膜组与对照组差异具有统计学意义。（2）FGFR4在卵巧囊的在位内膜组、异位内膜组及对照组的阳性表达率分别为59.4%、87.5%、46.7%，组间差异具有统计学意义。结论 FGF1及FGFR4可能有利于卵巢巧克力囊肿的发病及进展。卵巢巧克力囊肿患者的子宫内膜本身可能存在有利于疾病发生的基因，但还不足以致病，后来通过经血逆流至腹腔，在特定的腹腔环境下（如炎症），刺激、加强了致病因子的表达，从而导致了卵巢巧克力囊肿的发病。%Objective To explore the role of FGF1 and FGFR4 in endometriosis. Methods We collected 32 cases who were treated by surgery in the Gynecological Endoscopic Center of the first affiliated hospital of Harbin Medical University from June 2012 to November 2013, and confirmed EMS by postoperative pathology as the study group. We collected 30 patients who were treated by surgery because of Ovarian teratoma and Uterine fibroids in the same period and postoperative pathology as normal endometrium as the control group. We analysis the expression of FGF1 and FGFR4 in eutopic and ectopic endometrium, normal endometrium by immunohistochemistry. Results (1) The positive rate of FGF1 in eutopic and ectopic endometrium, normal endometrium were 37.5%, 53.1%, 23.3%. The difference among the three groups was not statistically significant (P=0.054), but the difference between ectopic endometrium and normal endometrium was statistically significant. (2) The positive rate of FGFR4 in eutopic and ectopic endometrium, normal endometrium were 59.4%, 87.5%, 46.7%.and the difference among the groups was statistically significant(P=0.003). Conclusions The current results indicated that FGF1 and FGFR4 may contribute to the formation and progression of Ovarian Endometriosis.We speculated that the gene of eutopic endometrium in Ovarian Endometriosis may be associated with a risk of developing EMS, but not enough to cause disease. When the endometrial tissue slough through patent fallopian tubes into the peritoneal cavity by retrograde menstruation, the abnormal environment of peritoneal cavity, such as inflammation, will stimulate and enhance the expression of FGF1,FGFR4 and other pathogenic factors, and cause the disease.