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孤啡肽在子宫腺肌病的表达及其与痛经的关系

Expression of orphanin in adenomyosis and its relationship with dysmenorrhea

摘要:

目的 研究孤啡肽在子宫腺肌病患者组织中的表达与患者痛经程度的关系.方法 收集吉林大学第二附属医院妇产科2007年12月至2008年6月,年龄41~52岁行全子宫切除术的子宫标本共55例,分为病例组(子宫腺肌病组)34例和对照组(子宫肌瘤组)21例,采用免疫组织化学方法检测病例组的在位内膜、异位内膜及对照组正常子宫内膜及肌层组织中孤啡肽的表达,并初步探讨孤啡肽表达与患者痛经关系的临床意义.结果 孤啡肽在病例组病灶及在位内膜组织中表达的计分分别为7.2±1.6及7.1±1.7,对照组在肌层及内膜组织中表达的计分分别为2.6±1.2及2.7±2.0,P<0.05;孤啡肽在病例组痛经组病灶及在位内膜组织中表达计分为7.5±1.5,7.4±1.5,在无痛经组病灶及在位内膜组织中表达的计分分别为5.1±1.2,5.0±1.2,P<0.05;孤啡肽的表达在病例组重度痛经组肌层及在位内膜组织表达最高计分分别为8.5±1.2,8.4±1.3,无痛经组计分分别为5.1±1.2,5.0±1.2,轻度痛经组计分分别为6.9±1.4,6.8±1.4,后两者比较差异无统计学意义(P>0.05),中度痛经、轻度痛经及无痛经组在位内膜及肌层组织中的表达逐渐降低.结论 孤啡肽在子宫腺肌病中的高表达可能是引起痛经的因素之一;患者的痛经程度与在位内膜的孤啡肽表达呈正相关,与病灶组织的孤啡肽表达也呈正相关;动态检测在位内膜中孤啡肽的表达,以监测子宫腺肌病的发展变化.

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abstracts:

Objective To study the expression of nociceptin in adenomyosis tissue and understand its relationship with the severity of dysmenorrhea. Methods The myometrial specimens were collected from 55 patients undergoing hysterectomy at our hospital during December 2007 and June 2008. Their mean age was 41 -52 years old. There were 34 adenomyosis patients in case group and 21 other patients in control group. Immunohistochemical staining was employed to detect nociceptin in eutopic endometrium and ectopic endometrial tissues in case group and normal endometrium and myometrial tissues in control group. Results The expression of nociceptin was significantly higher in the eutopic endometrial tissue ( 7. 1 ± 1.7 ) of case group than those in endometrial(2.7±2.0 ) and myometrial tissues of control group ( P < 0.05 ); The expression of nociceptin was higher in the eutopic endometrial tissue (7.4±1.5) of dysmenorrhea group than that of non-dysmenorrhea group ( 5.0 ± 1.2 ) in case group ( P < 0.05 ); The expression of nociceptin in eutopic endometrium and myometrium was the highest in severe dysmenorrhea group ( 8.4 ±1.3 ). And the non-dysmenorrhea and mild dysmenorrheal groups had no significant differences [(5.0 ± 1.2 ) vs (6.8 ± 1.4)]. And it decreased gradually in moderate dysmenorrhea, mild dysmenorrhea and nondysmenorrhea groups. Conclusion A high expression of nociceptin in adenomyosis may be one of the casual factors of dysmenorrhea. The severity of dysmenorrhea is positively correlated with the expression of nociceptin in eutopic endometrial tissue in case group ( r = 0.515, P = 0.034) and ectopic endometrium tissue. And the endometrial expression of nociceptin may be monitored dynamically to track the development of adenomyosis.

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