[蛋白质基因产物9.5免疫活性神经纤维及其在子宫内膜异位症腹膜病变中的临床意义]

Yao Hui-jiao, Huang Xiu-feng, Lu Bang-chun, Zhou Cai-yun, Zhang Jing, Zhang Xin-mei

Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

Zhonghua Fu Chan Ke Za Zhi. 2010 Apr;45(4):256-9.

OBJECTIVE

To investigate the association between distribution of protein gene product (PGP) 9.5-immunoactive nerve fibers in peritoneal endometriotic lesions and disease-associated pain symptoms.

METHODS

Thirty two peritoneal endometriotic lesions from patients with endometriosis (16 cases with pain and 16 cases without pain) and matched with 20 peritoneal tissues from patients with uterine leiomyoma without endometriosis were stained immunohistochemically for PGP9.5-immunoactive nerve fibers.

RESULTS

The positive rate and density of PGP9.5-immunoreactive nerve fibers in peritoneal endometriotic leision were 62% (10/16) and (3.8+/-1.7)/mm2 in endometriosis patients with pain, which were significantly higher than 19% (3/16) and (1.7+/-0.5)/mm2 in endometriosis patients without pain (P<0.05) and 25% (5/20) and (1.3+/-0.6)/mm2 in peritoneal tissues in women without endometriosis (P<0.05). However, no differences were found between endometriosis patients without pain and women without endometriosis (P>0.05). Moreover, the density of PGP9.5-immunoreactive nerve fibers in peritoneal lesions in endometriosis patients with pain was positively correlated with the severity of pain (r=0.855, P<0.05). In addition, the density of PGP9.5-immunoreactive nerve fibers in peritoneal lesions was statistically higher in endometriosis patients with chronic pelvic pain and (or) dysmenorrhea than those in endometriosis patients with other type of pain (P<0.05), which was not associated with active lesion, site and staging (P>0.05).

CONCLUSION

It suggested that PGP9.5-immunoreactive nerve fibers might confer the mechanism of pelvic pain with endometriosis.

目的

研究腹膜子宫内膜异位症病灶中蛋白基因产物（PGP）9.5免疫活性神经纤维的分布与疾病相关疼痛症状之间的关联。

方法

对32例子宫内膜异位症患者的腹膜子宫内膜异位症病灶（16例有疼痛，16例无疼痛）以及20例无子宫内膜异位症的子宫肌瘤患者的腹膜组织进行PGP9.5免疫活性神经纤维的免疫组织化学染色。

结果

有疼痛的子宫内膜异位症患者腹膜子宫内膜异位症病灶中PGP9.5免疫反应性神经纤维的阳性率和密度分别为62%（10/16）和（3.8±1.7）/mm²，显著高于无疼痛的子宫内膜异位症患者的19%（3/16）和（1.7±0.5）/mm²（P<0.05），以及无子宫内膜异位症女性腹膜组织中的25%（5/20）和（1.3±0.6）/mm²（P<0.05）。然而，无疼痛的子宫内膜异位症患者与无子宫内膜异位症女性之间未发现差异（P>0.05）。此外，有疼痛的子宫内膜异位症患者腹膜病灶中PGP9.5免疫反应性神经纤维的密度与疼痛严重程度呈正相关（r=0.855，P<0.05）。另外，慢性盆腔疼痛和（或）痛经的子宫内膜异位症患者腹膜病灶中PGP9.5免疫反应性神经纤维的密度在统计学上高于其他类型疼痛的子宫内膜异位症患者（P<0.05），且与活跃病灶、部位和分期无关（P>0.05）。