背景:很少有研究专门评估深层子宫内膜异位症中同源异型盒A10(HOXA10)和类固醇(雌激素和孕激素)受体的表达。来自评估腹膜和卵巢子宫内膜异位症的研究得出的结论通常是概括的,以解释整个疾病的发病机理。我们旨在评估HOXA10,雌激素受体α(ER-α)的表达,孕激素受体(PR),和PR-B在直肠乙状结肠子宫内膜异位症(RE)中,一种典型的深部疾病模型。
方法:我们使用来自18名连续患者的RE样品构建组织微阵列块。9例患者均在月经周期的增殖和分泌阶段接受手术。我们使用改良的Allred评分通过免疫组织化学定量蛋白质的表达。
结果:在18例患者中,有5例患者在分泌期结节间质中表达HOXA10。ER-α的表达(18例患者中有16例),PR(18例患者中有17例),在两个阶段,结节的腺体和基质中PR-B(18例患者中的17例)中等至强。在分泌期,PR(P=0.023)和PR-B(P=0.024)的表达均显着更高。
结论:HOXA10在RE中表达,它可能赋予子宫内膜异位病变的从头身份。ER-α,PR,PR-B在RE中强烈表达,这与以前研究腹膜和卵巢病变的研究不同。这表明3种类型的子宫内膜异位症的发病途径不同。
BACKGROUND: Very few studies have evaluated the expression of homeobox A10 (
HOXA10) and steroid (estrogen and progesterone) receptors exclusively in deep endometriosis. Conclusions drawn from studies evaluating peritoneal and ovarian endometriosis are usually generalized to explain the pathogenesis of the disease as a whole. We aimed to evaluate the expression of
HOXA10, estrogen receptor α (ER-α), progesterone receptor (PR), and PR-B in rectosigmoid endometriosis (RE), a typical model of deep disease.
METHODS: We used RE samples from 18 consecutive patients to construct tissue microarray blocks. Nine patients each were operated during the proliferative and secretory phases of the menstrual cycle. We quantified the expressions of proteins by immunohistochemistry using the modified Allred score.
RESULTS: The
HOXA10 was expressed in the stroma of nodules during the secretory phase in 5 of the 18 patients. Expression of ER-α (in 16 of 18 patients), PR (in 17 of 18 patients), and PR-B (17 of 18 patients) was moderate to strong in the glands and stroma of nodules during both phases. Expression of both PR (P = .023) and PR-B (P = .024) was significantly greater during the secretory phase.
CONCLUSIONS: The
HOXA10 is expressed in RE, where it likely imparts the de novo identity of endometriotic lesions. The ER-α, PR, and PR-B are strongly expressed in RE, which differs from previous studies investigating peritoneal and ovarian lesions. This suggests different routes of pathogenesis for each of the 3 types of endometriosis.