孕激素对不同类型子宫内膜增殖症组织中MMP-9及TIMP-1表达的影响  

Impact of progesterone on expression of MMP-9 and TIMP-1 in endometrial hyperplasia

作　　者：马会清[1] 魏晓强[1] 杨秀凤[1] 戴淑真[2] 

机构地区：[1]青岛大学医学院第二附属医院妇科,266042 [2]青岛大学医学院附属医院妇科

出　　处：《中国临床研究》2010年第5期356-358,共3页Chinese Journal of Clinical Research

摘　　要：目的研究不同类型子宫内膜增生组织中基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制因子-1(TIMP-1)的表达与意义,及孕激素治疗对其表达的影响,为孕激素在复杂型子宫内膜增生及不典型增生中的应用提供理论依据。方法应用免疫组化SP法检测20例正常增生期子宫内膜组织、61例子宫内膜增生症组织中MMP-9、TIMP-1蛋白的表达情况;对其中18例复杂型增生及23例不典型增生患者给予孕激素治疗3个月后,再次检测其子宫内膜组织MMP-9、TIMP-1蛋白的表达情况。结果在正常增生期子宫内膜、子宫内膜单纯型增生、复杂型增生、不典型增生组织中MMP-9、TIMP-1蛋白的阳性表达率呈递增趋势;其中复杂型增生、不典型增生组MMP-9、TIMP-1蛋白的表达高于正常增生期子宫内膜及单纯型增生组(P均<0.05)。复杂型增生及不典型增生组患者给予孕激素治疗3个月后MMP-9、TIMP-1蛋白的表达明显下调,与正常增生期子宫内膜、单纯型增生组相比差异无统计学意义(P均>0.05)。MMP-9、TIMP-1蛋白表达在子宫内膜增生症中呈正相关性(r=0.428,P<0.01)。结论MMP-9、TIMP-1在不同子宫内膜组织中表达异常可能与子宫内膜增生性疾病的进展有关。MMP-9、TIMP-1异常表达可促使子宫内膜细胞增殖及恶变,而孕激素可能通过减少子宫内膜MMP-9、TIMP-1蛋白的表达对子宫内膜复杂型增生及不典型增生发挥抑制作用。Objective To study the expression of matrix metalloproteinase-9（MMP-9） and tissue inhibitors of metalloproteinase-1（TIMP-1） in endometrial hyperplasia and to assess the changes of MMP-9 and TIMP-1 induced by progesterone in order to provide theoretical basis for progesterone treatment of complex and atypical endometrial hyperplasia.Methods The expressions of MMP-9 and TIMP-1 proteins were detected in 20 cases of normal proliferative endometrium and 61cases of endometrial hyperplasia by immunohistochemical staining S-P method;18 cases of complex hyperplasia and 23 cases of atypical hyperplasia were detected again after progesterone therapy for 3 months. Statistical analysis was performed by χ2 and Pearsons correlation analysis.Results The positive expression rates of MMP-9,TIMP-1 in normal proliferative endometrium（35.0%,25.0%）,simple endometrial hyperplasia（40.0%,25.0%）,complex endometrial hyperplasia（66.7%,38.9%） and atypical endometrial hyperplasia（82.6%,65.2%） were increased in ascending order. The expressions of MMP-9 and TIMP-1 in atypical hyperplasia and complex hyperplasia were significantly higher than those in normal proliferative endometrium and simple hyperplasia（all P〈0.05）.After 3 months of progesterone therapy,the expressions of MMP-9,TIMP-1 in atypical hyperplasia and complex hyperplasia were decreased,and there were no significant differences in the four groups（all P〉0.05）.A positive correlation was also found between MMP-9 and TIMP-1 expression.Conclusions Abnormal expressions of MMP-9 and TIMP-1 proteins might be associated with carcinogenesis of endometrium.The expressions of MMP-9 and TIMP-1 are useful biomarkers for early detection of endometrial hyperplasia. Progesterone is a good drug for atypical hyperplasia and complex hyperplasia possibly by influencing the expressions of MMP-9 and TIMP-1 in endometrium.

关 键 词：基质金属蛋白酶-9 金属蛋白酶组织抑制因子-1 子宫内膜增生症 孕激素 

分 类 号：R711.7[医药卫生—妇产科学]