TGF-β1、Smads在子宫内膜异位症中的表达和意义

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摘要目的通过比较卵巢子宫内膜异位囊肿(巧克力囊肿)患者异位囊壁、子宫在位内膜和其他卵巢良性肿瘤患者子宫内膜的组织学特点及分子生物学特征,探究TGF-β1、Smads在子宫内膜异位症(EMs)患者的表达和意义。方法募集行腹腔镜或宫腹腔镜联合术的巧克力囊肿患者,取其卵巢异位症囊壁组织作为卵巢异位症囊壁组,留取其子宫内膜组织作为子宫在位内膜组;同期行宫腹腔镜联合术的其它卵巢良性肿瘤患者,取其子宫内膜组织作为子宫内膜对照组。采用Masson染色、免疫组织化学法分别检测三种组织中纤维化形成和TGF-β1、Smads的表达情况。结果 (1)Masson染色显示,卵巢异位症囊壁组可见大量的纤维化沉积,子宫在位内膜组、子宫内膜对照组均未见明显纤维化蓝染。(2)卵巢异位症囊壁组TGF-β1、p-Smad2/3表达水平分别为(0.039±0.024)和(0.035±0.014)均高于子宫内膜对照组(0.018±0.012和0.023±0.004),差异有统计学意义(P＜0.05);子宫在位内膜组p-Smad2/3表达水平(0.034±0.011)高于子宫内膜对照组 (0.023±0.004)(P＜0.05);卵巢异位症囊壁组Smad7的表达水平(0.006±0.003)低于子宫在位内膜组(0.019±0.011)和子宫内膜对照组(0.041±0.023),差异有统计学意义(P＜0.01);子宫在位内膜组Smad7的表达含量较子宫内膜对照组低(P＜0.01)。结论 TGF-β1、p-Smad2/3在子宫内膜异位症中存在高表达,可能通过促进纤维母细胞增生、胶原蛋白的沉积导致异位病灶纤维化的形成,而Smad7作为抑制因子,在EMs中表达降低,对Smads介导的TGF-β1致纤维化的抑制作用减弱,也促使了子宫内膜异位症纤维化的进展。

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	李冰冰
	谢苗
	郭亚楠
	和翔宇
	刘雁峰

关键词 ：子宫内膜异位症, 转化生长因子β1, Smads, 纤维化

Abstract：Objective To compare the histological features and molecular biological characteristics between ectopic cystic wall and eutopic endometrium of patients with ovarian endometriosis and endometrium patients with other ovarian benign tumors, and to explore expression and significance of TGF-β1 and Smads in endometriosis. Methods The ovarian endometriosis patients underwent laparoscopic surgery were enrolled. Their ovarian ectopic cystic wall tissue was retained as the ectopic endometrium group and their uterus intimal tissue was retained as the eutopic endometrium group. In the same period, the patients with other ovarian benign tumors who underwent laparoscopic and hysteroscopic surgery were retained intimal tissue as the control endometrium group. The formation of fibrosis in tissues was detected by Masson staining, and the expression of TGF-β1and Smads in three tissues was detected by immunohistochemistry. Results (1) Masson staining showed that a large number of fibrotic deposits was observed in the ectopic endometrium group. No obvious fibrotic blue staining was observed in the eutopic endometrium and control endometrium groups. (2) The expression levels of TGF-β1 (0.039±0.024 vs. 0.018±0.012) and p-Smad2/3 (0.035±0.014 vs. 0.023±0.004) in ectopic endometrium group were higher than those in control endometrium group (P<0.01,P<0.05).The expression level of p-Smad2/3 (0.034±0.011 vs. 0.023±0.004) in eutopic endometrium group was higher than that in control endometrium group(P＜0.05). The expression of Smad7 (0.006±0.003 vs.0.019±0.011 and 0.041±0.023) in the ectopic endometriuml group was lower than those in the eutopic endometrium group and the control endometrium group (P<0.05, P<0.01). The expression of Smad7 (0.019±0.011 vs.0.041±0.023) in the eutopic endometrium group was lower than that in the control endometrium group (P<0.01). Conclusion The expressions of TGF-β1 and p-Smad2/3 are high in endometriosis, which may lead to fibrosis formation by promoting fibroblast proliferation and collagen deposition. While the expression of Smad7 inendometriosis, an inhibitor of fibrosis, was decreased and attenuated in the inhibition of Smads-mediated TGF-β1-induced fibrosis, contributing to the progression of fibrosis.

Key words： Endometriosis TGF-β1 Smads Fibrosis

收稿日期: 2020-09-30

ZTFLH:

R71

基金资助:济宁医学院教师科研扶持基金(JYFC2019KJ026);济医院字【2019】18号中西医结合治疗脾胃病创新团队

通讯作者: 刘雁峰(1061783316@qq.com)

引用本文:

李冰冰, 谢苗, 郭亚楠, 和翔宇, 刘雁峰. TGF-β1、Smads在子宫内膜异位症中的表达和意义[J]. 中国生育健康杂志, 2022, 33(1): 33-37. LI Bingbing, XIE Miao, GUO Yanan, HE Xiangyu, LIU Yanfeng. Expression and significance of TGF-β1 and Smads in endometriosis. Chinese Journal of Reproductive Health, 2022, 33(1): 33-37.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2022/V33/I1/33

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