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目的探讨子宫富于细胞平滑肌瘤中肥大细胞增加的机制。方法采用双重免疫组化染色法,检测30例子宫富于细胞平滑肌瘤(观察组)、30例普通型平滑肌瘤(对照组)和15例子宫平滑肌肉瘤(肉瘤组)患者瘤组织肥大细胞中增殖抗原 Ki-67的表达,同时检测肥大细胞和平滑肌瘤细胞中趋化因子正常 T 细胞表达和分泌的活性调节蛋白(RANTES)、Eotaxin、单核细胞趋化蛋白1(MCP-1)和转化生长因子β(TGF-β)的表达。结果 3组患者子宫平滑肌瘤组织中,肥大细胞基本未见 Ki-67的表达。观察组 RANTES、Eotaxin 和 TGF-β的阳性表达率分别为78%、89%、91%,而在对照组和肉瘤组中其阳性表达率分别为60%、81%、86%和39%、44%、59%,观察组中3种趋化因子的表达均较对照组和肉瘤组明显升高,差异均有统计学意义(P<0.01)。其中,RANTES 和 Eotaxin 的阳性表达率均与肥大细胞数量呈正相关关系(r=0.655,0.543,P<0.01)。而在3组瘤组织中,均未见MCP-1的表达。结论子宫富于细胞平滑肌瘤中肥大细胞数量的增加,主要是由于肥大细胞向肿瘤局部募集所致。肥大细胞的局部募集与平滑肌瘤细胞分泌的 RANTES 和 Eotaxin 有关,而与 TGF-β和 MCP-1无关。
Objective To investigate the mechanism of mast cell proliferation in uterine leiomyoma. Methods Twenty patients with uterine leiomyoma (observation group), 30 cases of common type leiomyoma (control group) and 15 cases of uterine leiomyosarcoma (sarcoma) were examined by double immunohistochemistry. (RANTES), Eotaxin, monocyte chemoattractant protein-1 (MCP-1) in mast cells and leiomyoma cells, and the expression of Ki-67, And transforming growth factor beta (TGF-beta) expression. Results In the three groups of patients with uterine leiomyomas, mast cells basically showed no expression of Ki-67. The positive rates of RANTES, Eotaxin and TGF-β in the observation group were 78%, 89% and 91% respectively, while the positive rates in the control group and the sarcoma group were 60%, 81%, 86% and 39% 44% and 59% respectively. The expression of three chemokines in the observation group was significantly higher than that in the control group and sarcoma group (P <0.01). Among them, the positive expression rates of RANTES and Eotaxin were positively correlated with the number of mast cells (r = 0.655, 0.543, P <0.01). However, no expression of MCP-1 was found in the three tumor tissues. Conclusion The increase of the number of mast cells in uterine rich leucoma is mainly due to the recruitment of mast cells to the tumor. Local recruitment of mast cells is associated with RANTES and Eotaxin secreted by leiomyoma cells, but not with TGF-β and MCP-1.