内异停方对内异症患者PD-L1表达的影响
发布时间：2018-07-16 09:34
【摘要】：目的：1、证实程序性死亡因子(PD-1)的配体PD-L1在在位内膜、异位内膜中表达；对比观察PD-L1在子宫肌瘤患者内膜组织、子宫内膜异位症(endometriosis,EMs)患者在位及异位内膜中的表达情况,分析是否存在差异；探讨PD-L1在EMs发病中的作用和临床意义。2、研究内异停方对卵巢巧克力囊肿(ovarian endometriosis,OEM)患者病灶PD-L1表达的影响,探讨内异停治疗EMs的机制,寻求内异症治疗的新突破。方法：1、选取病例对照的研究方法,对PD-L1在各组织中的表达进行研究。标本均源于江苏省中医院2014年3月～2015年6住院手术治疗的患者。腺肌症患者18例,取其异位及在位内膜；20例巧囊患者的异位内膜；18例子宫肌瘤患者在位内膜、病灶及正常肌壁组织。应用免疫组化方法检测PD-L1在各组织中的表达情况。2、将2014年3月～2015年12月江苏省中医院门诊内异停治疗2月,经手术确诊为巧囊的患者20人作为试验组,未治疗直接手术的患者20人作为对照组。对比观察两组异位内膜中PD-L1的表达情况,并进行统计学分析。结果：1、(1)PD-L1广泛表达于内膜组织中,但相较于肌瘤组,腺肌症患者的阳性表达率及强度更高；(2)各组病灶组织中也均有表达且存在差异,其中巧囊病灶表达阳性率最高,腺肌症次之,肌瘤最低；(3)腺肌症患者病灶与内膜中PD-L1的表达存在一定的线性关系,子宫肌瘤患者病灶与内膜PD-L1的表达不存在线性关系。(4)正常肌壁组织PD-L1少量表达。2、中药组PD-L1表达总阳性率80%,强阳占20%(4/20),中阳15%(3/20),弱阳45%(9/20),阴性20%(4/20)；对照组总阳性率达100%,强阳占60%(12/20),中阳35%(7/20),弱阳5%(1/20),阴性0%(0/20)。两组差异性比较P为0,差异有非常显著的统计学意义,中药组阳性率明显下降。结论：1、PD-L1在内异症患者在位、异位内膜中均有较高的表达,异位内膜与在位内膜中PD-L1的表达阳性率存在一定的线性关系。对比子宫肌瘤组的低表达,我们认为内异症的发病与PD-L1存在相关性。2、内异停方可以降低EMs患者异位病灶PD-L1的表达,PD-L1在EMs的发生发展中发挥了重要的作用。
[Abstract]:Objective to confirm the expression of PD-L1 in eutopic endometrium and ectopic endometrium, and to observe the expression of PD-L1 in eutopic and ectopic endometrium in patients with endometriosis and endometriosis. To study the effect of PD-L1 on the expression of PD-L1 in the lesions of patients with ovarian's chocolate cyst (ovarian), to explore the mechanism of treatment of EMs, and to seek a new breakthrough in the treatment of endometriosis by analyzing the effect of PD-L1 on the pathogenesis of EMs and the clinical significance of PD-L1, and to explore the effect of Neiyidingfang on the expression of PD-L1 in the lesions of patients with ovarian chocolate cyst (ovarian). Methods: 1. The expression of PD-L1 in all tissues was studied by case-control method. The specimens were collected from 6 hospitalized patients in Jiangsu Provincial Hospital of traditional Chinese Medicine from March 2014 to 2015. 18 cases of adenomyosis, 20 cases of ectopic endometrium and 20 cases of ectopic endometrium, 18 cases of hysteromyoma and 18 cases of normal muscle wall. The expression of PD-L1 in various tissues was detected by immunohistochemical method. Twenty patients diagnosed as skillful sac by operation for 2 months from March 2014 to December 2015 in Jiangsu Provincial Hospital of traditional Chinese Medicine were selected as experimental group. Twenty patients without direct operation were used as control group. The expression of PD-L1 in ectopic endometrium was observed and statistically analyzed. Results: (1) PD-L1 was widely expressed in endometrial tissue, but the positive rate and intensity of PD-L1 were higher in adenomyosis than in leiomyoma. Adenomyosis followed by leiomyoma. (3) there was a linear relationship between PD-L1 expression in adenomyosis and the expression of PD-L1 in endometrium. There was no linear relationship between the expression of PD-L1 and the expression of PD-L1 in uterine leiomyoma. (4) there was no linear relationship between the expression of PD-L1 and PD-L1. (4) the positive rate of PD-L1 was 80 in the traditional Chinese medicine group, 20% (4 / 20) in the strong positive group, 15% (3 / 20) in the Zhongyang group, 45% (9 / 20) in the weak positive group and 20% (4 / 20) in the negative group. The total positive rate of the control group was 100. The positive rate was 60% (12 / 20), the positive was 35% (7 / 20), the weak positive was 5% (1 / 20), and the negative was 0 / 20 (0 / 20). The difference between the two groups (P = 0) was statistically significant, and the positive rate of TCM group decreased significantly. Conclusion there is a high expression of PD-L1 in ectopic endometrium and there is a linear relationship between the expression of PD-L1 in ectopic endometrium and the positive rate of PD-L1 in eutopic endometrium. Compared with the low expression of PD-L1 in patients with hysteromyoma, we believe that the pathogenesis of endometriosis has a correlation with PD-L1, and the expression of PD-L1 in ectopic lesions of EMs can be reduced by Neiyidanfang. PD-L1 plays an important role in the occurrence and development of EMs.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9
[Abstract]:Objective to confirm the expression of PD-L1 in eutopic endometrium and ectopic endometrium, and to observe the expression of PD-L1 in eutopic and ectopic endometrium in patients with endometriosis and endometriosis. To study the effect of PD-L1 on the expression of PD-L1 in the lesions of patients with ovarian's chocolate cyst (ovarian), to explore the mechanism of treatment of EMs, and to seek a new breakthrough in the treatment of endometriosis by analyzing the effect of PD-L1 on the pathogenesis of EMs and the clinical significance of PD-L1, and to explore the effect of Neiyidingfang on the expression of PD-L1 in the lesions of patients with ovarian chocolate cyst (ovarian). Methods: 1. The expression of PD-L1 in all tissues was studied by case-control method. The specimens were collected from 6 hospitalized patients in Jiangsu Provincial Hospital of traditional Chinese Medicine from March 2014 to 2015. 18 cases of adenomyosis, 20 cases of ectopic endometrium and 20 cases of ectopic endometrium, 18 cases of hysteromyoma and 18 cases of normal muscle wall. The expression of PD-L1 in various tissues was detected by immunohistochemical method. Twenty patients diagnosed as skillful sac by operation for 2 months from March 2014 to December 2015 in Jiangsu Provincial Hospital of traditional Chinese Medicine were selected as experimental group. Twenty patients without direct operation were used as control group. The expression of PD-L1 in ectopic endometrium was observed and statistically analyzed. Results: (1) PD-L1 was widely expressed in endometrial tissue, but the positive rate and intensity of PD-L1 were higher in adenomyosis than in leiomyoma. Adenomyosis followed by leiomyoma. (3) there was a linear relationship between PD-L1 expression in adenomyosis and the expression of PD-L1 in endometrium. There was no linear relationship between the expression of PD-L1 and the expression of PD-L1 in uterine leiomyoma. (4) there was no linear relationship between the expression of PD-L1 and PD-L1. (4) the positive rate of PD-L1 was 80 in the traditional Chinese medicine group, 20% (4 / 20) in the strong positive group, 15% (3 / 20) in the Zhongyang group, 45% (9 / 20) in the weak positive group and 20% (4 / 20) in the negative group. The total positive rate of the control group was 100. The positive rate was 60% (12 / 20), the positive was 35% (7 / 20), the weak positive was 5% (1 / 20), and the negative was 0 / 20 (0 / 20). The difference between the two groups (P = 0) was statistically significant, and the positive rate of TCM group decreased significantly. Conclusion there is a high expression of PD-L1 in ectopic endometrium and there is a linear relationship between the expression of PD-L1 in ectopic endometrium and the positive rate of PD-L1 in eutopic endometrium. Compared with the low expression of PD-L1 in patients with hysteromyoma, we believe that the pathogenesis of endometriosis has a correlation with PD-L1, and the expression of PD-L1 in ectopic lesions of EMs can be reduced by Neiyidanfang. PD-L1 plays an important role in the occurrence and development of EMs.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9
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