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目的探讨TRAIL/TRAILR系统在子宫内膜癌细胞凋亡中的作用。方法选择正常子宫内膜组织(对照组)、早期子宫内膜腺癌组织(EEC组)、晚期子宫内膜腺癌组织(AEC组)各30例,各组织分别进行免疫组化、蛋白质印迹法检测TRAIL及其受体蛋白质表达量的变化和表达部位。结果 3组中TRAIL表达量无统计学差异(P>0.05);AEC组较对照组、EEC组DR4、DR5较对照组明显减少(P<0.01),EEC组DR4、DR5明显增加(P<0.01);EEC组DcR1、DcR2与对照组比较无统计学差异(P>0.05),AEC组较对照组及EEC组明显增加(P<0.01);EEC组OPG与对照组比较无统计学差异(P>0.05);AEC组较对照组及EEC组明显减少(P<0.01)。TRAIL及受体阳性表达主要定位表达于子宫内膜腺上皮细胞、血管平滑肌内皮细胞的细胞膜和胞浆等部位。结论 TRAIL在正常子宫内膜、早期子宫内膜腺癌及晚期子宫内膜腺癌发展过程中的表达无明显变化;子宫内膜腺癌早期死亡受体DR4,DR5表达明显减少,诱骗受体无显著变化,子宫内膜腺癌细胞凋亡过程中可能得以免疫耐受与被保护,引起子宫内膜腺癌细胞的凋亡逃逸;在子宫内膜腺癌的晚期阶段,子宫内膜腺癌细胞的死亡受体DR4,DR5,诱骗受体DcR1,DcR2的表达均明显增加,OPG的表达显著减少,TRAIL/TRAILR系统显著失衡,子宫内膜腺癌细胞生长迅速,易发生转移。OPG与子宫内膜腺癌细胞的凋亡逃逸是否有关尚需进一步研究。
Objective To investigate the role of TRAIL / TRAILR in apoptosis of endometrial carcinoma cells. Methods Thirty normal control and endometrial adenocarcinoma tissues (EEC group) and 30 cases of advanced endometrial adenocarcinoma (AEC group) were selected. All the tissues were immunohistochemically identified by Western blotting Detection of TRAIL and its receptor protein expression changes and expression sites. Results There was no significant difference in the expression of TRAIL in the three groups (P> 0.05). The levels of DR4 and DR5 in the AEC group were significantly lower than those in the control group and the EEC group (P <0.01) ). There was no significant difference in DcR1 and DcR2 between EEC group and control group (P> 0.05), AEC group was significantly higher than that of EEC group and EEC group (P <0.01). There was no significant difference between EEC group and control group > 0.05). The AEC group was significantly lower than the control group and EEC group (P <0.01). The expression of TRAIL and its receptor was mainly located in the endometrial glandular epithelial cells and the cell membrane and cytoplasm of vascular smooth muscle endothelial cells. Conclusion The expression of TRAIL in normal endometrium, early endometrial adenocarcinoma and advanced endometrial adenocarcinoma has no significant change. The expressions of DR4 and DR5 in early stage of endometrial adenocarcinoma are significantly reduced, Significant changes in endometrial adenocarcinoma cell apoptosis process may be immune tolerance and protection, causing endometrial adenocarcinoma cell apoptosis escape; in the advanced stage of endometrial adenocarcinoma, endometrial adenocarcinoma cells DR5, DR5, decoy receptors DcR1 and DcR2 were significantly increased, OPG expression was significantly reduced, TRAIL / TRAILR system was significantly imbalance, endometrial adenocarcinoma cells grew rapidly, prone to metastasis. OPG and endometrial adenocarcinoma cell apoptosis escape is still in need of further study.