CAJ | 학술논문

目的探讨子宫内膜异位症(内异症)患者腹膜病灶中神经蛋白基因产物9.5(PGP9.5)的表达及其与内异症疼痛的关系.方法应用免疫组化Envision二步法检测32例内异症患者(内异症组,其中伴与不伴疼痛者各16例)的腹膜病灶组织和同期行腹腔镜手术并经病理学检查确诊为子宫肌瘤且不伴疼痛者20例(对照组)的正常腹膜组织中PGP9.5的表达.结果内异症组伴与不伴疼痛者腹膜病灶和对照组腹膜组织中PGP9.5表达阳性率及阳性神经纤维密度分别为62%(10/16)和(3.8±1.7)条/mm~2、19%(3/16)和(1.7±0.5)条/mm~2、25%(5/20)和(1.3±0.6)条/mm~2,内异症组伴疼痛者腹膜病灶中PGP9.5阳性神经纤维密度及阳性率均显著高于内异症组不伴疼痛者和对照组,差异均有统计学意义(P均<0.05);但内异症组不伴疼痛者腹膜病灶中PGP9.5阳性神经纤维密度及阳性率与对照组比较,差异均无统计学意义(P均>0.05).内异症组伴疼痛者腹膜病灶中PGP9.5阳性神经纤维密度与患者疼痛程度呈正相关关系(r=0.855,P<0.05).内异症组伴痛经和(或)慢性盆腔痛患者腹膜病灶中,PGP9.5阳性神经纤维密度显著高于伴其他疼痛类型者,差异也有统计学意义(P<0.05),但PGP9.5阳性神经纤维密度与病灶活性、病灶部位及疾病分期均无关(P均>0.05).结论 PGP9.5阳性神经可能参与内异症疼痛的发生机制.
목적 탐토자궁내막이위증(내이증)환자복막병조중신경단백기인산물9.5(PGP9.5)적표체급기여내이증동통적관계.방법 응용면역조화Envision이보법검측32례내이증환자(내이증조,기중반여불반동통자각16례)적복막병조조직화동기행복강경수술병경병이학검사학진위자궁기류차불반동통자20례(대조조)적정상복막조직중PGP9.5적표체.결과 내이증조반여불반동통자복막병조화대조조복막조직중PGP9.5표체양성솔급양성신경섬유밀도분별위62%(10/16)화(3.8±1.7)조/mm~2、19%(3/16)화(1.7±0.5)조/mm~2、25%(5/20)화(1.3±0.6)조/mm~2,내이증조반동통자복막병조중PGP9.5양성신경섬유밀도급양성솔균현저고우내이증조불반동통자화대조조,차이균유통계학의의(P균<0.05);단내이증조불반동통자복막병조중PGP9.5양성신경섬유밀도급양성솔여대조조비교,차이균무통계학의의(P균>0.05).내이증조반동통자복막병조중PGP9.5양성신경섬유밀도여환자동통정도정정상관관계(r=0.855,P<0.05).내이증조반통경화(혹)만성분강통환자복막병조중,PGP9.5양성신경섬유밀도현저고우반기타동통류형자,차이야유통계학의의(P<0.05),단PGP9.5양성신경섬유밀도여병조활성、병조부위급질병분기균무관(P균>0.05).결론 PGP9.5양성신경가능삼여내이증동통적발생궤제.
Objective To investigate the association between distribution of protein gene product (PGP) 9.5-immunoactive nerve fibers in peritoneal endometriotic lesions and disease-associated pain symptoms.Methods Thirty two peritoneal endometriotic lesions from patients with endometriosis (16 cases with pain and 16 cases without pain) and matched with 20 peritoneal tissues from patients with uterine leiomyoma without endometriosis were stained immunohistochemically for PGPg.5-immunoactive nerve fibers.Results The positive rate and density of PGP9.5-immunoreactive nerve fibers in peritoneal endometriotic leision were 62% (10/16) and (3.8 ± 1.7)/mm~2 in endometriosis patients with pain, which were significantly higher than 19% (3/16) and (1.7 ± 0.5)/mm~2 in endometriosis patients without pain (P <0.05) and 25% (5/20) and (1.3±0.6) /mm~2 in peritoneal tissues in women without endometriosis (P <0.05).However, no differences were found between endometriosis patients without pain and women without endometriosis (P > 0.05) .Moreover, the density of PGP9.5-immunoreactive nerve fibers in peritoneal lesions in endometriosis patients with pain was positively correlated with the severity of pain (r = 0.855, P < 0.05).In addition, the density of PGP9.5-immunoreactive nerve fibers in peritoneal lesions was statistically higher in endometriosis patients with chronic pelvic pain and(or) dysmenorrhea than those in endometriosis patients with other type of pain(P < 0.05), which was not associated with active lesion, site and staging (P > 0.05).Conclusion It suggested that PGP9.5-immunoreactive nerve fibers might confer the mechanism of pelvic pain with endometriosis.