Fujishita A, Nakane P K, Koji T, Masuzaki H, Chavez R O, Yamabe T, Ishimaru T
Department of Obstetrics and Gynecology, Nagasaki University School of Medicine, Japan.
Fertil Steril. 1997 May;67(5):856-64. doi: 10.1016/s0015-0282(97)81397-0.
To clarify the role of ovarian steroids in the development and progression of endometriosis, estrogen receptors (ERs) and progesterone receptors (PRs) were localized by immunohistochemistry, and ER messenger RNA (mRNA) was detected by in situ hybridization in the uterine endometrium and in normal and altered pelvic peritoneum.
Retrospective and prospective study.
Nagasaki University School of Medicine, Nagasaki, Japan.
PATIENT(S): A retrospective study of 61 formalin-fixed uterine endometria and normal and altered pelvic peritonea from patients suffering from various gynecologic diseases was conducted. In addition, in 22 fresh frozen tissue specimens, ER mRNA expression was evaluated prospectively.
MAIN OUTCOME MEASURE(S): In formalin-fixed tissues, ER and PR were localized immunohistochemically. The results of immunohistochemical staining were scored from 0 to 4, depending on the signal intensity and frequency of positive cells. In fresh frozen specimens, ER mRNA expression was assessed by nonradioactive in situ hybridization using thymine-thymine dimerized oligonucleotide probes.
The highest score of ERs and PRs was observed in the epithelial and stromal cells of the normal uterine endometrium at the early proliferative phase of the menstrual cycle. The ER and PR scores declined throughout the secretory phase. In typical endometriotic lesions, the ER and PR scores were constantly high independent of the menstrual cycle. The expression pattern of ER mRNA was mostly in parallel with that of ERs. In typical endometriosis, ERs and PRs were found in both glandular epithelial cells and their surrounding stromal cells. Expression of ER mRNA was found in typical endometriotic peritonea and in pelvic peritoneum with columnar epithelial cells, but not in normal pelvic peritoneum (mesothelium). Estrogen receptors and PRs were negative in mesothelium, but were positive in the nuclei of fibroblasts in the connective tissue.
CONCLUSION(S): We demonstrated the expression of ERs, ER mRNA, and PRs in the columnar cells in pelvic peritonea and typical endometriosis, but not in normal mesothelium. These results suggest that endometriosis may originate from the columnar cells with ERs and PRs in the pelvic peritoneal lining.
为阐明卵巢甾体激素在子宫内膜异位症发生发展中的作用，采用免疫组织化学方法对雌激素受体（ERs）和孕激素受体（PRs）进行定位，并通过原位杂交技术检测子宫子宫内膜以及正常和病变盆腔腹膜中的ER信使核糖核酸（mRNA）。
回顾性和前瞻性研究。
日本长崎大学医学院。
对61例因各种妇科疾病接受治疗的患者的福尔马林固定子宫子宫内膜以及正常和病变盆腔腹膜进行回顾性研究。此外，前瞻性评估了22例新鲜冷冻组织标本中的ER mRNA表达。
在福尔马林固定组织中，采用免疫组织化学方法对ER和PR进行定位。根据阳性细胞的信号强度和频率，将免疫组织化学染色结果从0至4进行评分。在新鲜冷冻标本中，使用胸腺嘧啶 - 胸腺嘧啶二聚体寡核苷酸探针通过非放射性原位杂交评估ER mRNA表达。
在月经周期早期增殖期的正常子宫子宫内膜上皮和基质细胞中观察到ERs和PRs的最高评分。在整个分泌期，ER和PR评分下降。在典型的子宫内膜异位症病变中，ER和PR评分始终较高，与月经周期无关。ER mRNA的表达模式大多与ERs的表达模式平行。在典型的子宫内膜异位症中，在腺上皮细胞及其周围的基质细胞中均发现了ERs和PRs。在典型的子宫内膜异位症腹膜和具有柱状上皮细胞的盆腔腹膜中发现了ER mRNA的表达，但在正常盆腔腹膜（间皮）中未发现。雌激素受体和PRs在间皮中为阴性，但在结缔组织中的成纤维细胞核中为阳性。
我们证明了ERs、ER mRNA和PRs在盆腔腹膜柱状细胞和典型子宫内膜异位症中表达，但在正常间皮中不表达。这些结果表明，子宫内膜异位症可能起源于盆腔腹膜衬里中具有ERs和PRs的柱状细胞。
