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目的:探讨转化生长因子-β1(transforming growth factor-β1,TGF-β1)在宫腔粘连和子宫纵隔患者宫腔镜术后子宫内膜中的不同表达与预后之间的关系。方法:选取2014年6月至2015年5月在西安交通大学第二附属医院行宫腔镜手术的患者96例,其中宫腔粘连、子宫纵隔患者各48例,用免疫组化SP法检测TGF-β1在患者术后3周子宫内膜中的表达情况,术后3个月按NASR评分将宫腔粘连和子宫纵隔患者分为预后良好组、预后一般组和预后不良组,用方差分析及卡方检验分析各组数据之间的差异。结果:宫腔镜术后3个月,子宫纵隔手术预后优于宫腔粘连,差异有统计学意义(χ~2=13.714,P=0.000);免疫组化染色结果显示,在宫腔粘连患者中,TGF-β1在预后不良组中的表达水平(n=16,2.94±0.70)明显高于预后一般组(n=20,1.65±0.76)和预后良好组(n=12,1.08±0.79),差异有统计学意义(P=0.000,P=0.000),在预后一般组中的表达高于预后良好组,差异有统计学意义(P=0.045);在子宫纵隔患者中,TGF-β1在预后不良组中的表达水平(n=6,2.58±0.97)明显高于预后一般组(n=12,1.25±0.54)和预后良好组(n=30,0.78±0.55),差异有统计学意义(P=0.000,P=0.000),在预后一般组中的表达高于预后良好组,差异有统计学意义(P=0.030)。结论:宫腔粘连和子宫纵隔宫腔镜手术预后差异可能与TGF-β1在子宫内膜中的异常表达有关,其预后不良可能与TGF-β1在子宫内膜中的过度表达有关。
OBJECTIVE: To investigate the relationship between the expression of transforming growth factor-β1 (TGF-β1) and the prognosis in endometrial tissue after hysteroscopy in patients with intrauterine adhesions and uterine cancer. Methods: 96 cases of hysteroscopic surgery in the Second Affiliated Hospital of Xi’an Jiaotong University from June 2014 to May 2015 were selected, of which 48 cases were intrauterine adhesions and uterine mediastinum. Immunohistochemical SP method was used to detect the expression of TGF- β1 in the endometrium after 3 weeks of operation. The patients with intrauterine adhesions and mediastinum were divided into good prognosis group, general prognosis group and poor prognosis group by NASR score at 3 months after operation. The square test analyzes the differences between the data in each group. Results: The prognosis of mediastinum surgeries was better than that of intrauterine adhesions at 3 months after hysteroscopy (χ ~ 2 = 13.714, P = 0.000). Immunohistochemical staining showed that in patients with intrauterine adhesions (N = 16,2.94 ± 0.70) was significantly higher in the poor prognosis group (n = 20,1.65 ± 0.76) and in the well-prognosis group (n = 12,1.08 ± 0.79) , The difference was statistically significant (P = 0.000, P = 0.000), the expression in the general prognosis group was higher than that in the good prognosis group, the difference was statistically significant (P = 0.045); in uterine mediastinal patients, TGF- The poor prognosis group (n = 6,2.58 ± 0.97) was significantly higher than the general prognosis group (n = 12,1.25 ± 0.54) and the prognosis group (n = 30,0.78 ± 0.55), the difference was statistically significant (P = 0.000, P = 0.000). The expression in the general prognosis group was higher than that in the good prognosis group, the difference was statistically significant (P = 0.030). CONCLUSION: The differences in the prognosis between uterine adhesions and uterine mediastinal hysteroscopy may be related to the abnormal expression of TGF-β1 in endometrium. The poor prognosis may be related to the overexpression of TGF-β1 in uterine endometrium.