To investigate the expression of TLR4 in eutopic and ectopic endometrium of women with en-dometriosist EM) and its clinical significance.MethodsSpecimens of ectopic endometrium( n=45) and homologous eutopic en-dometrium (n=32) from women with EM and specimens of endometrium from women without EM (n=32) were used for immuno-histochemical analysis of TLR4. Semi-quantitative analysis was used to assess the average value of staining.ResultsEndome-trial samples from EM patients and controls showed cytoplasmic TLR4 immunoreactivities mainly in the luminal and glandular epithelium. The expression of TLR4 in eutopic and ectopic endometrium of EM patients was weaker than that of controls (P< 0.01). The expression of TLR4 in the ectopic endometrium was significantly stronger than that in eutopic endometrium of EM women (P<0.01). No statistically significant difference were found in expression of TLR4 between stage I ~ II and stage III ~ IV of endometriosis (P >0.05).The decreased expressions of TLR4 might be associated with the pathogenesis of en-dometriosis.%目的 检测Toll样受体4(TLR4)在正常子宫内膜、子宫内膜异位症(EMs)患者在位内膜和异位内膜中的表达情况,探讨TLR4在EMs发病中的作用.方法 选择EMs患者的卵巢异位内膜45例(EMs异位内膜组)和相对应的在位子宫内膜32例(EMs在位内膜组),32例非EMs患者子宫内膜组织为对照组.采用免疫组织化学二步法检测各组内膜组织中TLR4的表达情况,以及TLR4在EMs不同临床分期的异位内膜组织中的表达,作半定量分析后进行组间比较.结果 EMs患者异位内膜、在位内膜及对照组子宫内膜中,TLR4蛋白均有不同程度表达,主要表达于子宫内膜腺上皮和腔上皮.TLR4蛋白在EMs患者异位内膜、在位内膜的表达均低于对照组子宫内膜,差异均有统计学意义(均P＜0.01),但在异位内膜中表达要高于在位内膜的表达,差异有统计学意义(P＜0.01).TLR4蛋白在Ⅰ～Ⅱ期EMs患者异位内膜的表达与Ⅲ～Ⅳ期患者异位内膜的表达比较,差异无统计学意义(P ＞0.05).结论 EMs患者在位和异位内膜组织中的TLR4表达下降,但在异位内膜表达高于在位内膜,TLR4可能参与了EMs的发生、发展.
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