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目的探讨蛋白基因产物9.5(protein gene product 9.5,PGP9.5)标记的神经纤维、神经生长因子(nervegrowth factor,NGF)及神经轴突生长抑制性蛋白NOGO-B(neural axon growth repressible protein,NOGO-B)在子宫内膜异位症(endometriosis,EMs)患者子宫内膜的表达及其与痛经的关系。方法选择行手术治疗的EMs患者26例,对照组选择同期因其他妇科病变(子宫肌瘤、宫颈病变等)行手术治疗的患者30例。应用免疫组织化学方法检测PGP9.5、NGF、NOGO-B的表达情况。根据视觉模拟评分(VAS)对痛经程度进行分级,术中根据修正的美国生育学会(Ameri-can Fertility Society,AFS)评分对EMs病变程度进行分期,分析神经因子与痛经程度及EMs分期的相关性。结果EMs组PGP9.5、NGF和NOGO-B均有表达,对照组仅见NGF和NOGO-B表达。EMs组NGF和NOGO-B的表达明显高于对照组,差异均有统计学意义[(2.36±1.79)个/每高倍视野(HP)vs.(1.04±0.99)个/HP,(2.79±2.43)个/HP vs.(1.38±1.36)个/HP,P均<0.05];PGP9.5、NGF和NOGO-B表达与痛经VAS评分呈正相关(r=0.465、0.354和0.332,P均<0.05),与EMs的AFS分期无相关性(P>0.05)。结论 PGP9.5、NGF和NOGO-B在EMs中的高表达提示神经因子可能与EMs发病相关,神经纤维在痛经发生中可能起到重要作用。
Objective To investigate the effect of nerve root growth factor (NGF) and neural axon growth repressible protein NOGO-B (NGF) marked by protein gene product 9.5 (PGP9.5) B) Expression of endometrium in patients with endometriosis (EMs) and its relationship with dysmenorrhea. Methods Twenty-six patients with EMs underwent surgical treatment. Thirty patients in the control group underwent surgery for other gynecological diseases (uterine fibroids and cervical lesions) during the same period. Immunohistochemistry was used to detect the expression of PGP9.5, NGF and NOGO-B. The degree of dysmenorrhea was graded according to the visual analogue scale (VAS). According to the revised Ameri-can Fertility Society (AFS) score, the degree of dysplasia was staged. The correlation between neurological factors and dysmenorrhea and EMs stage was analyzed . Results The expressions of PGP9.5, NGF and NOGO-B in EMs group were all significantly higher than those in control group, while NGF and NOGO-B were only found in control group. The expression of NGF and NOGO-B in EMs group was significantly higher than that in the control group [(2.36 ± 1.79) / HP vs. (1.04 ± 0.99) /HP, (2.79 ± 2.43 P <0.05). The expressions of PGP9.5, NGF and NOGO-B were positively correlated with VAS score of dysmenorrhea (r = 0.465,0.354 and 0.332, P <0.05 respectively) ), No correlation with the AFS stage of EMs (P> 0.05). Conclusion The overexpression of PGP9.5, NGF and NOGO-B in EMs suggests that neurological factors may be related to the pathogenesis of EMs. Nerve fibers may play an important role in the pathogenesis of dysmenorrhea.