Dufournet Charlotte, Uzan Catherine, Fauvet Raffaèle, Cortez Annie, Siffroi Jean-Pierre, Daraï Emile
Service d'Anatomie Pathologie, Hôpital Tenon, AP-HP, UFR Saint Antoine, Paris VI, France.
J Reprod Immunol. 2006 Jun;70(1-2):151-62. doi: 10.1016/j.jri.2005.11.003. Epub 2005 Dec 27.
Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. Apoptosis, a physiological process by which multicellular organisms eliminate superfluous cells, is altered in tumor tissue. Here we studied the expression of the apoptosis-related proteins p53, bcl-2, bax, p21 and fas in proliferative (n=9) and secretory (n=9) endometrium, and in peritoneal (n=11), ovarian (n=20) and colorectal (n=20) endometriosis, by qualitative and semi-quantitative immunohistochemical methods using the percentage of positive cells and HSCORE analysis. In endometrium, p53, p21 and fas expression was low, whereas bax and bcl-2 expression was elevated. Using HSCORE analysis, only bcl-2 expression varied during the menstrual cycle (48.9+/-34.2% in the proliferative phase, 11.5+/-24.7% in the secretory phase, p=0.01). Using HSCORE analysis, p53 expression was higher in ovarian endometriosis than in peritoneal (p<0.0001) and colorectal endometriosis (p=0.03). P21 expression was higher in ovarian endometriosis than in peritoneal (p=0.01) and colorectal endometriosis (p=0.01). Bcl-2 expression was lower in ovarian endometriosis than in peritoneal (p=0.0002) and colorectal endometriosis (p<0.0001). Fas expression was higher in peritoneal endometriosis than in ovarian (p=0.02) and colorectal endometriosis (p=0.008). In conclusion, these results confirm the involvement of apoptosis in the pathogenesis of endometriosis. Moreover, expression of apoptosis-related proteins varies according to the location of endometriosis suggesting the involvement of different apoptotic pathways.
子宫内膜异位症的定义为子宫外存在子宫内膜腺体和间质。细胞凋亡是多细胞生物体清除多余细胞的生理过程，在肿瘤组织中会发生改变。在此，我们采用定性和半定量免疫组织化学方法，通过阳性细胞百分比和HSCORE分析，研究了增殖期（n = 9）和分泌期（n = 9）子宫内膜，以及腹膜（n = 11）、卵巢（n = 20）和结肠直肠（n = 20）子宫内膜异位症中凋亡相关蛋白p53、bcl-2、bax、p21和fas的表达。在子宫内膜中，p53、p21和fas表达较低，而bax和bcl-2表达升高。使用HSCORE分析，仅bcl-2表达在月经周期中有所变化（增殖期为48.9±34.2%，分泌期为11.5±24.7%，p = 0.01）。使用HSCORE分析，p53在卵巢子宫内膜异位症中的表达高于腹膜（p < 0.0001）和结肠直肠子宫内膜异位症（p = 0.03）。P21在卵巢子宫内膜异位症中的表达高于腹膜（p = 0.01）和结肠直肠子宫内膜异位症（p = 0.01）。Bcl-2在卵巢子宫内膜异位症中的表达低于腹膜（p = 0.0002）和结肠直肠子宫内膜异位症（p < 0.0001）。Fas在腹膜子宫内膜异位症中的表达高于卵巢（p = 0.02）和结肠直肠子宫内膜异位症（p = 0.008）。总之，这些结果证实细胞凋亡参与了子宫内膜异位症的发病机制。此外，凋亡相关蛋白的表达因子宫内膜异位症的位置而异，提示不同凋亡途径的参与。
