中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2009年
5期
324-327
,共4页
卢邦春%黄秀峰%周彩云%许泓%林俊%张信美
盧邦春%黃秀峰%週綵雲%許泓%林俊%張信美
로방춘%황수봉%주채운%허홍%림준%장신미
子宫内膜异位症%平滑肌瘤%子宫内膜%神经纤维%免疫组织化学%痛经
子宮內膜異位癥%平滑肌瘤%子宮內膜%神經纖維%免疫組織化學%痛經
자궁내막이위증%평활기류%자궁내막%신경섬유%면역조직화학%통경
Endometriosis%Leiomyoma%Endometrium%Nerve fibres%Immunohistochemistry%Dysmenorrhea
目的 探讨子宫腺肌病(腺肌病)患者子宫内膜神经纤维分布与腺肌病发病以及痛经的关系.方法 选择经手术切除子宫的患者74例,其中腺肌病组32例(包括有痛经22例,无痛经10例),子宫肌瘤(肌瘤)组42例(包括有痛经15例,无痛经27例).应用免疫组化Envision二步法检测子宫内膜神经纤维的分布,分别用抗神经微丝蛋白(NF)抗体与抗蛋白基因产物9.5(PGP9.5)抗体检测有髓与无髓神经纤维.结果 腺肌病和肌瘤组有痛经者的子宫内膜功能层PGP9.5免疫反应阳性神经纤维检出率分别为64%(14/22)和67%(10/15),PGP9.5免疫反应阳性神经纤维密度分别为0.6(0～9.4)和0.6(0～6.0)条/mm2;两组分别比较,差异均无统计学意义(P均＞0.05);两组均无NF免疫反应阳性神经纤维检出.腺肌病和肌瘤组无痛经者的子宫内膜功能层均无神经纤维检出.腺肌病组痛经者与无痛经者的子宫内膜基底层PGP9.5免疫反应阳性神经纤维检出率和神经纤维密度分别为64%(14/22)和1.1(0～12.0)条/mm2、50%(5/10)和0.6(0～3.0)条/mm2;NF免疫反应阳性神经纤维检出率和神经纤维密度分别为23%(5/22)和0(0～0.6)条/mm2、20%(2/10)和0(0～1.0)条/mm2.肌瘤组痛经者与无痛经者的子宫内膜基底层PGP9.5免疫反应阳性神经纤维检出率和神经纤维密度分别为80%(12/15)和1.6(0～10.0)条/mm2、44%(12/27)和0(0～5.0)条/mm2;NF免疫反应阳性神经纤维检出率和神经纤维密度分别为40%(6/15)和0(0～0.4)条/mm2、15%(4/27)和0(0～1.0)条/mm2;子宫内膜基底层PGP9.5和NF免疫反应阳性神经纤维密度在腺肌病和肌瘤组痛经者间以及在无痛经者间比较,差异均无统计学意义(P均＞0.05),但两组痛经者子宫内膜基底层PGP9.5免疫反应阳性神经纤维密度均显著高于同组无痛经者(P均＜0.05).结论 子宫内膜PGP9.5免疫反应阳性神经纤维可能参与痛经的发生;NF免疫反应阳性神经纤维可能与痛经的发生无关;子宫内膜神经纤维增生可能与疾病本身无关.
目的 探討子宮腺肌病(腺肌病)患者子宮內膜神經纖維分佈與腺肌病髮病以及痛經的關繫.方法 選擇經手術切除子宮的患者74例,其中腺肌病組32例(包括有痛經22例,無痛經10例),子宮肌瘤(肌瘤)組42例(包括有痛經15例,無痛經27例).應用免疫組化Envision二步法檢測子宮內膜神經纖維的分佈,分彆用抗神經微絲蛋白(NF)抗體與抗蛋白基因產物9.5(PGP9.5)抗體檢測有髓與無髓神經纖維.結果 腺肌病和肌瘤組有痛經者的子宮內膜功能層PGP9.5免疫反應暘性神經纖維檢齣率分彆為64%(14/22)和67%(10/15),PGP9.5免疫反應暘性神經纖維密度分彆為0.6(0～9.4)和0.6(0～6.0)條/mm2;兩組分彆比較,差異均無統計學意義(P均＞0.05);兩組均無NF免疫反應暘性神經纖維檢齣.腺肌病和肌瘤組無痛經者的子宮內膜功能層均無神經纖維檢齣.腺肌病組痛經者與無痛經者的子宮內膜基底層PGP9.5免疫反應暘性神經纖維檢齣率和神經纖維密度分彆為64%(14/22)和1.1(0～12.0)條/mm2、50%(5/10)和0.6(0～3.0)條/mm2;NF免疫反應暘性神經纖維檢齣率和神經纖維密度分彆為23%(5/22)和0(0～0.6)條/mm2、20%(2/10)和0(0～1.0)條/mm2.肌瘤組痛經者與無痛經者的子宮內膜基底層PGP9.5免疫反應暘性神經纖維檢齣率和神經纖維密度分彆為80%(12/15)和1.6(0～10.0)條/mm2、44%(12/27)和0(0～5.0)條/mm2;NF免疫反應暘性神經纖維檢齣率和神經纖維密度分彆為40%(6/15)和0(0～0.4)條/mm2、15%(4/27)和0(0～1.0)條/mm2;子宮內膜基底層PGP9.5和NF免疫反應暘性神經纖維密度在腺肌病和肌瘤組痛經者間以及在無痛經者間比較,差異均無統計學意義(P均＞0.05),但兩組痛經者子宮內膜基底層PGP9.5免疫反應暘性神經纖維密度均顯著高于同組無痛經者(P均＜0.05).結論 子宮內膜PGP9.5免疫反應暘性神經纖維可能參與痛經的髮生;NF免疫反應暘性神經纖維可能與痛經的髮生無關;子宮內膜神經纖維增生可能與疾病本身無關.
목적 탐토자궁선기병(선기병)환자자궁내막신경섬유분포여선기병발병이급통경적관계.방법 선택경수술절제자궁적환자74례,기중선기병조32례(포괄유통경22례,무통경10례),자궁기류(기류)조42례(포괄유통경15례,무통경27례).응용면역조화Envision이보법검측자궁내막신경섬유적분포,분별용항신경미사단백(NF)항체여항단백기인산물9.5(PGP9.5)항체검측유수여무수신경섬유.결과 선기병화기류조유통경자적자궁내막공능층PGP9.5면역반응양성신경섬유검출솔분별위64%(14/22)화67%(10/15),PGP9.5면역반응양성신경섬유밀도분별위0.6(0～9.4)화0.6(0～6.0)조/mm2;량조분별비교,차이균무통계학의의(P균＞0.05);량조균무NF면역반응양성신경섬유검출.선기병화기류조무통경자적자궁내막공능층균무신경섬유검출.선기병조통경자여무통경자적자궁내막기저층PGP9.5면역반응양성신경섬유검출솔화신경섬유밀도분별위64%(14/22)화1.1(0～12.0)조/mm2、50%(5/10)화0.6(0～3.0)조/mm2;NF면역반응양성신경섬유검출솔화신경섬유밀도분별위23%(5/22)화0(0～0.6)조/mm2、20%(2/10)화0(0～1.0)조/mm2.기류조통경자여무통경자적자궁내막기저층PGP9.5면역반응양성신경섬유검출솔화신경섬유밀도분별위80%(12/15)화1.6(0～10.0)조/mm2、44%(12/27)화0(0～5.0)조/mm2;NF면역반응양성신경섬유검출솔화신경섬유밀도분별위40%(6/15)화0(0～0.4)조/mm2、15%(4/27)화0(0～1.0)조/mm2;자궁내막기저층PGP9.5화NF면역반응양성신경섬유밀도재선기병화기류조통경자간이급재무통경자간비교,차이균무통계학의의(P균＞0.05),단량조통경자자궁내막기저층PGP9.5면역반응양성신경섬유밀도균현저고우동조무통경자(P균＜0.05).결론 자궁내막PGP9.5면역반응양성신경섬유가능삼여통경적발생;NF면역반응양성신경섬유가능여통경적발생무관;자궁내막신경섬유증생가능여질병본신무관.
Objective To investigate nerve fibers distribution in endometrium of adenomyosis and their relationship with dysmenorrhea. Methods Endometrial tissue was sampled from 74 hysterectomy specimens including 32 cases with adenomyosis and 42 cases with uterine fibroids. Two-step Envision immunohistochemical staining was used to detect distribution of nerve fibers in endometrium. Highly specific polyclonal rabbit anti-protein gene product 9.5 (PGP9.5) and monoclonal mouse anti-neurofilament protein (NF) were used to demonstrate both myelinated and unmyelinated nerve fibers in endometrium in women with adenomyosis and uterine fibroids. Results The positive rate of PGP9.5 immunoreactive nerve fibers in the functional layer of endometrium of pain patients were with 64%(14/22) in adenomyosis and 67% (10/15) in uterine fibroids. And their density were 0.6(0-9.4)/mm2 and 0.6(0-6.0)/mm2 without reaching statistical difference (P> 0.05). No expression of NF could be detected in the functional layer of endometrium of adenomyosis and uterine fibroids. There were no PGP9.5 immunoreactive nerve fibers in the functional layer of endometrium in non-pain women with adenomyosis and uterine fibroids. Moreover, No NF immunoreactive nerve fibers in the functional layer of endometrium were shown in non-pain patients with adenomyosis and uterine fibroids. PGP9.5 immunoreactive nerve fibers and the nerve density in the basal layer of endometrium were 64%(14/22), 1.1(0-12.0)/mm2 in pain adenomyosis and 50%(5/10), 0.6(0-3.0)/mm2 in non-pain adenomyosis. NF immunoreactive nerve fibers and the density in the basal layer of endometrium were 23%(5/22),(0-0.6)/mm2 in pain adenomyosis and 20% (2/10),(0-1.0)/mm2 in non-pain adenomyosis. PGP9.5 immunoreactive nerve non-pain fibroids. NF immunoreactive nerve fibers and the nerve density in the basal layer of endometrium were 40%(6/15),0(0-0.4)/mm2 in pain fibroids and 15%(4/27),0(0-1.0)/mm2 in non-pain fibroids. There was no statistical different PGP9.5 and NF immunoreactive nerve fibers distribution in basal layer of endometrium between pain adenomyosis and pain fibroids or between non-pain adenomyosis and non-pain fibroids (all P>0.05). However, PGP9.5 immunoreactive nerve fibers density in basal layer of endometrium was higher in pain adenomyosis and fibroids when compared with non-pain adenomyosis and fibroids(P<0.05). Conclusions PGP9.5 immunoreactive nerve fibers might confer the occurrence of pelvic pain, however, NF immunoreactive nerve fibers may not involved in the pathogenesis of pain.
