摘要
目的探讨息肉状子宫内膜异位症的纤维化程度、雌孕激素表达及血管生成相关分子的表达,进一步了解其组织病理学特征。方法回顾分析复旦大学附属妇产科医院2014年4月至2020年8月经手术治疗且病理诊断为息肉状子宫内膜异位症的42例患者的临床病理资料,并收集病理确诊的19例卵巢内膜样囊肿、20例子宫腺肌病、20例深部内异症、20例子宫内膜息肉患者的病灶组织作为对照组,使用Masson染色及免疫组化染色测定各组病灶的纤维化程度、雌孕激素受体表达及血管生成相关分子的表达情况。结果42例息肉状子宫内膜异位症患者的平均发病年龄为41.24岁,最常见的临床表现为盆腔肿块(24例)。免疫组化显示:息肉状子宫内膜异位症与卵巢内膜样囊肿、子宫腺肌病、深部子宫内膜异位症相比,子宫内膜异位相关疾病纤维化程度较低;但与子宫内膜息肉相比,息肉状子宫内膜异位症纤维化程度显著增加。雌激素受体β(estrogen receptor-β,ER-β)表达上升,孕激素受体同工酶B(progesterone receptor B,PR-B)表达下调,血管密度较高。结论息肉状子宫内膜异位症是一种纤维化程度较低、雌激素受体表达水平较高、血供较为丰富的一种特殊亚型的内异症,预后一般良好。
Objective To investigate the degree of fibrosis,the expression of estrogen and progesterone receptors,and the expression of angiogenesis-related molecules in polypoid endometriosis,with the aim of further elucidating its histopathological characteristics.Methods The study retrospectively analyzed the clinicopathological data of 42 patients diagnosed with polypoid endometriosis through surgical treatment at Obstetrics and Gynecology Hospital,Fudan University from Apr 2014 to Aug 2020.Additionally,tissue samples from 19 cases of ovarian endometriotic cysts,20 cases of adenomyosis,20 cases of deep infiltrating endometriosis,and 20 cases of endometrial polyps,all pathologically confirmed,were collected as a control group.The degree of fibrosis,the expression of estrogen and progesterone receptors,and the expression of angiogenesis-related molecules in the lesions of each group were determined using Masson staining and immunohistochemistry.Results The mean age of onset of the 42 patients with polypoid endometriosis was 41.24 years.And the most usual clinical manifestation is pelvic mass(24/42 patients).Immunohistochemical experiments showed that polypoid endometriosis was less fibrotic than ovarian endometriotic cysts,adenomyosis and deep infiltrating endometriosis but more fibrotic than endometrial polyps.Polypoid endometriosis also has a higher vascular density,increased expression of estrogen receptor-β(ER-β),and down-regulated expression of progesterone receptor B(PR-B).Conclusion Polypoid endometriosis is a distinct subtype of endometriosis characterized by a lower degree of fibrosis,higher levels of estrogen receptor expression,and relatively rich vascularization,generally associated with a favorable prognosis.
作者
易云华
刘惜时
聂姬婵
YI Yun-hua;LIU Xi-shi;NIE Ji-chan(Department of Gynecology,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2024年第5期757-764,771,共9页
Fudan University Journal of Medical Sciences
