摘要目的 探讨多囊卵巢综合征(PCOS)患者的成熟与未成熟卵泡的颗粒细胞神经生长因子(NGF)及其受体p75NTR、TrkA的表达,以了解神经生长因子及其受体在卵泡发育和卵母细胞成熟过程中的作用.方法 免疫组织化学SABC法检测NGF、p75NTR、TrkA蛋白在颗粒细胞的表达.并与生殖内分泌正常(IVF)患者进行比较.结果 54例标本(IVM-PCOS 9例,IVF-PCOS 16例,IVF-Normal 29例),NGF蛋白阳性49例,3组间表达强度差异有统计学意义(P均＜0.05),以PCOS-IVF组表达最强,其余2组差异无统计学意义(P＞0.05);TrkA蛋白阳性41例,绝大多数IVF病例呈阳性,而IVM仅2例中、低表达,IVF-PCOS与IVF-Normal差异无统计学意义(P均＞0.05,);NGF蛋白、TrkA蛋白高表达组E_2水平显著高于中、低表达组(P＜0.05).075NTR蛋白51例阳性,各组间差异无统计学意义(P均＞0.05).结论 人类发育卵泡、成熟卵泡颗粒细胞存在NGF表达,TrkA主要在成熟卵泡表达,NGF-TrkA可能参与卵泡发育、成熟,NGF过度表达可能是PCOS的病理机制之一.

abstractsObjective To investigate the possible role of nerve growth factors (NGF) and its receptors in ovarian follicle development,and detect the difference between polycystic ovarian symdrome (PCOS) and normal control.Methods Immunohistochemisty was applied to detect the expression of NGF,p75NTR,TrkA in ovarian follicle granulosa cells.Results In 54 cases (including 9 cases of IVM-PCOS,16 cases of IVF-PCOS and 29 cases of IVF-Normal),49 cases showed NGF protein positive in granulose cells with significance difference between groups (P＜0.05),and especially NGF was the strongest expressed factor in IVF-PCOS group but there was no remarkable difference between the other two groups in the expression of NGF.41 were TrkA protein positive,almost all IVF cases were TrkA protein positive while only 2 in IVM and there was no remarkable difference in expression of TrkA between IVF PCOS and IVF Normal(P＞0.05).The cases with stronger expression of NGF or TrkA had higher estradiol level than that of lower expression group (P＜0.05).51 cases had positive expression of p75 NTR protein but there was no significant difference between groups (P＞0.05).Conclusions TrkA is expressed in mature ovarian follicle,and the interaction of NGF-TrkA may be involved in ovarian follicle development,and overexpression of NGF may be associated with PCOS development.