Wang Fei, Shi Xixi, Qin Xiaoyan, Wen ZeQing, Zhao Xingbo, Li Changzhong
Department of Obstetrics & Gynecology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, PR China.
Department of Obstetrics & Gynecology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, PR China.
Eur J Obstet Gynecol Reprod Biol. 2015 Nov;194:101-5. doi: 10.1016/j.ejogrb.2015.08.027. Epub 2015 Aug 28.
To investigate the expression of CD56 in endometrial samples from patients with adenomyosis and its relationship with menstrual cycle phase and severity of dysmenorrhea.
40 patients with histologically proved adenomyosis (proliferative n=20; secretory n=20) and dysmenorrhea were examined in this study, control groups includes 20 patients with adenomyosis without dysmenorrhea (main complaint: menorrhagia) and 20 patients without adenomyosis who had undergone hysterectomy for non-endometrial pathology (no dysmenorrhea medical history). Immunohistochemical staining against CD56 was performed for the eutopic and ectopic endometrium from patients with adenomyosis and the control samples. The expression of CD56 was determined by calculating the H-score and the severity of dysmenorrhea was determined using the visual analogue scale. The menstrual cycle status and the disease severity were compared to the levels of staining.
RESULT(S): CD56 was expressed mainly in the endometrial glandular epithelium in patients with adenomyosis and normal endometrium. The epithelial staining intensity of CD56 in ectopic lesions of adenomyosis with dysmenorrhea was obviously higher than in the corresponding eutopic endometrium and control groups (P<0.01). There were no statistical differences in the expression between normal endometrium, eutopic endometrium of adenomyosis with dysmenorrhea and adenomyostic samples without dysmenorrhea. For eutopic endometrium in adenomyosis with dysmenorrhea, expression was higher in the secretory phases than in the proliferative phase (P<0.05). The increased CD56 immunoreactivity correlated with the severity of dysmenorrhea (spearman rho=0.84, P<0.01).
CONCLUSION(S): These findings suggest that the expression of CD56 in adenomyosis is positively associated with the severity of dysmenorrhea. Endometrial glandular epithelium is likely to secrete more CD56 and stimulating nerve growth in the stroma, which could then play a role in the pathogenesis of adenomoysis-related dysmenorrhea.
探讨CD56在子宫腺肌病患者子宫内膜样本中的表达及其与月经周期阶段和痛经严重程度的关系。
本研究检查了40例经组织学证实为子宫腺肌病（增殖期n = 20；分泌期n = 20）且有痛经的患者，对照组包括20例无痛经的子宫腺肌病患者（主要症状：月经过多）和20例因非子宫内膜病变接受子宫切除术的无子宫腺肌病患者（无痛经病史）。对子宫腺肌病患者的在位和异位子宫内膜以及对照样本进行抗CD56免疫组织化学染色。通过计算H评分来确定CD56的表达，并使用视觉模拟量表来确定痛经的严重程度。将月经周期状态和疾病严重程度与染色水平进行比较。
CD56主要表达于子宫腺肌病患者和正常子宫内膜的子宫内膜腺上皮。有痛经的子宫腺肌病异位病变中CD56的上皮染色强度明显高于相应的在位子宫内膜和对照组（P<0.01）。正常子宫内膜、有痛经的子宫腺肌病在位子宫内膜和无痛经的子宫腺肌病样本之间的表达无统计学差异。对于有痛经的子宫腺肌病在位子宫内膜，分泌期的表达高于增殖期（P<0.05）。CD56免疫反应性增加与痛经严重程度相关（斯皮尔曼相关系数=0.84，P<0.01）。
这些发现表明，子宫腺肌病中CD56的表达与痛经严重程度呈正相关。子宫内膜腺上皮可能分泌更多的CD56并刺激基质中的神经生长，进而在子宫腺肌病相关痛经的发病机制中发挥作用。
