Department of Obstetrics & Gynaecology, BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, Canada.
PLoS One. 2019 Jul 17;14(7):e0219064. doi: 10.1371/journal.pone.0219064. eCollection 2019.
Deep infiltrating endometriosis (DIE) is defined as an endometriotic lesion penetrating to a depth of >5 mm and is associated with pelvic pain, but the underlying mechanisms are unclear. Our objective is to investigate whether plasminogen activator inhibitor-1 expression (PAI-1) in endometriotic tissues is increased in women with DIE.
In this blinded in vitro study, immunohistochemistry and Histoscore were used to examine the expression of PAI-1 in glandular epithelium (GECs) and stroma (SCs) in a total of 62 women: deep infiltrating uterosacral/rectovaginal endometriosis (DIE; n = 13), ovarian endometrioma (OMA; n = 14), superficial peritoneal uterosacral/cul-de-sac endometriosis (SUP; n = 23), uterine (eutopic) endometrium from women with endometriosis (UE; n = 6), and non-endometriosis eutopic endometrium (UC; n = 6). The following patient characteristics were also collected: age, American Fertility Society stage, hormonal suppression, phase of menstrual cycle, dysmenorrhea score and deep dyspareunia score.
PAI-1 expression in GECs and SCs of the DIE group was significantly higher than that of SUP group (p = 0.01, p = 0.01, respectively) and UE group (p = 0.03, p = 0.04, respectively). Interestingly, increased PAI-1 expression in GECs and SCs was also significantly correlated with increased dysmenorrhea (r = 0.38, p = 0.01; r = 0.34, p = 0.02, respectively).
We found higher expression of PAI-1 in DIE, and an association between PAI-1 and worse dysmenorrhea.
深部浸润型子宫内膜异位症（DIE）定义为子宫内膜异位症病变穿透深度>5 毫米，并与盆腔疼痛相关，但潜在机制尚不清楚。我们的目的是研究 DIE 患者的组织中纤溶酶原激活物抑制剂-1 表达（PAI-1）是否增加。
在这项盲法体外研究中，使用免疫组织化学和 Histoscore 检查了 62 名女性的子宫内膜异位症组织中 PAI-1 在腺体上皮（GECs）和基质（SCs）中的表达：深部浸润型子宫骶骨/直肠阴道子宫内膜异位症（DIE；n=13）、卵巢子宫内膜瘤（OMA；n=14）、浅表腹膜子宫骶骨/子宫陷凹子宫内膜异位症（SUP；n=23）、子宫内膜异位症患者的子宫（在位）子宫内膜（UE；n=6）和非子宫内膜异位症在位子宫内膜（UC；n=6）。还收集了以下患者特征：年龄、美国生育协会分期、激素抑制、月经周期阶段、痛经评分和深部性交痛评分。
DIE 组的 GECs 和 SCs 中 PAI-1 的表达明显高于 SUP 组（p=0.01，p=0.01）和 UE 组（p=0.03，p=0.04）。有趣的是，GECs 和 SCs 中 PAI-1 表达的增加也与痛经的增加显著相关（r=0.38，p=0.01；r=0.34，p=0.02）。
我们发现 DIE 中 PAI-1 的表达较高，且 PAI-1 与更严重的痛经相关。
