摘要
目的探讨子宫结合带的超微结构特点及间隙连接蛋白43(connexin43,Cx43)在子宫结合带中的表达与卵巢子宫内膜异位症发生的关系。方法选择2008年11月至2009年7月在内蒙古医科大学附属医院因卵巢子宫内膜异位症行手术切除子宫30例和同期因宫颈上皮内瘤样病变Ⅲ级,卵巢良性肿瘤切除子宫者30例为对照组。采用免疫组化方法从组织学及分子水平探讨Cx43在卵巢子宫内膜异位症患者子宫结合带中的表达情况,并同时各取2例做透视电镜,观察卵巢子宫内膜异位症子宫结合带的超微结构特点。结果在正常对照组子宫结合带中Cx43表达与对照组子宫内膜一样,增生期高于分泌期(0.1540±0.0164,0.1407±0.0179;P<0.05);在卵巢子宫内膜异位症患者的子宫结合带中,Cx43表达在增生期、分泌期无差异(0.1147±0.0213,0.1162±0.0139;P>0.05),且明显低于正常对照组。在卵巢子宫内膜异位症组中,细胞间间隙远,细胞核及密斑未见增大,细胞未见明显增大,但核扭曲变形,细胞器较多,腺上皮细胞呈桥粒连接,且微绒毛较丰富,肥大细胞形态异常,且与肌细胞相邻;以上所有的特点在两组的子宫结合带处更显著。结论子宫结合带中结构和功能的异常,与卵巢子宫内膜异位症的发生有关,Cx43在子宫结合带中的表达减少与卵巢子宫内膜异位症的发生有关。
Objective To study the ultrastructure of the inner and outer myometrium, in the ovarian endometriosis, especially the inner one, and meanwhile to explore the expression of Connexin 43 protein and its significance in the uterus junction zone of patients with ovarian endometriosis. Methods Multiple samples were studied using transmission electron microscopy. The SABC immunohistochemical method was used to detect the expression of Connexin 43 in the Uterine junction zone in 30 cases of EM and 30 matched normal uterine. Results In uteri with ovarian endometriosis, the myocytes exhibited cellular was not hypertrophy. The cytoplasmic myofilaments were also less abundant. Abundant intermediate filaments formed cytoplasmic aggregates. The nuclei were fusiform in shape with blunt ends, centrally placed in the myocyte, and with a irregular outline prominent nucleoli and peripherally arranged nuclear chromatin. The bands were no longer and there were fewer caveolae. The rough endoplasmic reticulum and Golgi apparatus were little more. All features were more prominent at the junctional zone. The optical density of Connexin 43 expression were significantly lower in Endometriosis with endometrium （0.0943±0.0050） and JZ（0.1540±0.0164） than in control group （P〈0.05）, respectively. The expressions of Cx43 were significantly higher in control group of proliferative phase with endometrium（0.0943±0.0050, 0.0801± 0.0054, P〈0.05） and JZ（0.1540±0.0164, 0.1407±0.0179, P〈0.05） than secretory, but there was no significantly difference in ovarian endometriosis between proliferative phase and secretory neither with outer myometrium nor with JZ. Furthermore, the expression of Connexin 43 was no difference in outer myometrium neither in outermyometrium nor in control group（P〉0.05）. Conclusion The myocytes of uteri harboring outer myometrium are ultrastructurally different from those of normal uteri. These ultrastructural changes suggest a possible defect in myometrial contractility. The down-regulation of CX43 in the JZ may play important roles in ovarian endometriosis, the relevant molecular mechanism requires further investigation.
出处
《中华临床医师杂志（电子版）》
CAS
2013年第24期161-164,共4页
Chinese Journal of Clinicians(Electronic Edition)
