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目的探讨子宫内膜异位症(内异症)在位内膜中神经纤维的表达。方法 2008年1月~2009年12月检查确诊为内异症的患者共64例,按美国生育协会修正分期(rAFS)分为4组,Ⅰ期11例(1组)、Ⅱ期12例(2组)、Ⅲ期20例(3组)、Ⅳ期21例(4组),手术确诊无内异症者10例作为阴性对照组(0组)。通过诊断性刮宫取得的子宫内膜组织分别用神经标志物生长相关蛋白-43(GAP-43)及S-100进行免疫组化测定,比较4组内异症者及非内异症者的在位内膜神经纤维密度及内异症者的神经纤维与内膜腺体的最近距离。结果 rAFS分期各组及对照组的神经纤维密度的差异有统计学意义(P均<0.001);4组内异症者的神经纤维与内膜腺体的最近距离差异无统计学意义(P均>0.05)。结论内异症病情进展与在位内膜神经纤维密度密切相关,与神经纤维及内膜腺体间的距离无相关性。
Objective To investigate the expression of nerve fiber in endometrium of endometriosis (endometriosis). Methods Totally 64 patients diagnosed as endometriosis from January 2008 to December 2009 were divided into 4 groups according to the American Society of Reproductive Aging (rAFS), 11 cases of stage Ⅰ (group 1), 12 cases of stage Ⅱ 2 in group), 20 in stage Ⅲ (3 groups) and 21 in stage Ⅳ (4 groups). There were 10 patients with endometriosis diagnosed as negative control group (group 0). The endometrial tissues obtained by diagnostic curettage were detected by immunohistochemistry with neuromarker growth-associated protein-43 (GAP-43) and S-100, respectively, and compared between 4 patients with endometriosis and non-endometriosis Endometrial nerve fiber density and endometriosis of nerve fibers and endometrial glands closest distance. Results There was significant difference in nerve fiber density between rAFS staging group and control group (P <0.001). There was no significant difference in the nearest distance between nerve fiber and endometrial gland in endometriosis > 0.05). Conclusion The progress of endometriosis is closely related to the density of eutopic endometrium nerve fibers, but not to the distance between nerve fibers and endometrial glands.