功能性子宫出血子宫内膜AQP1和ER的表达特点

摘要

Objective:To detect the expression of aquaporin1 (AQP1) and estrogen receptor (ER) in en-dometrium of patients with dysfunctional uterine bleeding as compared to women with normal menstrual cycles and to investigate the pathogenesis of dysfunctional uterine bleeding (DUB) .Methods:45 women with dysfunctional u-terine bleeding (15 from simple hyperplasia ,15 from complex hyperplasia and 15 from atypical hyperplasia)and 20 women with normal menstrual cycle(10 from proliferative phase endometrium ,10 from secretoryphase) were includ-ed in the study .Examined the expression of ER、AQP1 in each tissue by streptavidin peroxidase immunohistochem-istry .Then analyze the data with statistics method .Results:① The density of AQP1 positive microvessel were higher in the secretary phase than that in the proliferative phase .The staining intensity and density of AQP1 positive microvessel decreased significantly in simple hyperplasia group and then gradually increased in complex hyperplasia and atypical hyperplasia groups .② The expression of estrogen receptor (ER)of secretary phase were significantly higher than that of the proliferative phase ,and its higher in dysfunctional uterine bleeding than that in normal men-strual cycle .The ER expression gradually decreased in simple hyperplasia ,complex hyperplasia and atypical hyper-plasia groups .Conclusion:Decreased expression of AQP1 and increased expression of ER may be involved in the oc-currence of dysfunctional uterine bleeding .In the process of endometrial hyperplasia (from simple hyperplasia ,com-plex hyperplasia to atypical hyperplasia groups ) ,the expression of AQP1 gradually increased instead of the decrease of ER ,we could suppose that the abnormal expression of ER and AQP1 plays an important role in the process and transformation of endometrial hyperplasia .%目的：通过对功血患者不同病理阶段的子宫内膜及正常内膜组织的水通道蛋白1（AQP1）、雌激素受体（ER）的表达情况进行研究，探讨AQP1及ER在功血形成、发展和演变中的作用。方法：随机选取正常增生期及分泌期子宫内膜各10例作为对照，选取功血患者经宫腔镜手术后病理证实为简单型增生、复杂性增生、不典型增生的子宫内膜各15例作为研究对象，共65例标本。用生物素蛋白免疫组化法（SP法）检测各组织上AQP1，ER的表达情况，对数据进行统计分析。结果：① AQP1阳性的微血管密度增生期与分泌期比较有显著性差异。AQP1阳性的微血管密度单纯性增生组较正常对照组显著降低，在复杂性增生与不典型增生子宫内膜中逐渐增高。不典型增生组较单纯性增生组显著增高。②在正常子宫内膜中，ER从增生期到分泌期呈下降趋势。ER染色强度研究组较对照组明显增强，有统计学意义。ER在单纯性增生，复杂性增生与不典型增生三组间的表达呈下降趋势，单纯型增生与不典型增生组之间的差异有统计学意义。结论：AQP1蛋白的低表达、ER受体的高表达可能参与了功血的发生。子宫内膜从单纯型增生、复杂型增生到不典型增生的发展过程中，AQP1的表达逐渐增加而ER的表达呈下降趋势，推测其与子宫内膜病变的发展和演变有着紧密的联系。