골반강 외 자궁내막증에서 Survivin 발현
Expression of Survivin in extrapelvic endometriosis
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목적: 골반강 외 자궁내막증 조직에서 새로운 세포고사 저해 단백질인 survivin의 발현을 정상자궁내막과 난소 자궁내막종으로 비교 조사함으로써 골반강 외 자궁내막증의 병태생리에 세포고사가 어떻게 작용하는지 알아보고자 하였다. 방법: 본 연구는 수술 후 조직검사에서 골반강 외 자궁내막증으로 진단된 14예를 복강경으로 진단되어 제거한 난소 자궁내막 종조직 13예와 자궁내막증이 없고 자궁근종으로 자궁을 적출한 정상자궁내막 34예를 대조군으로 하여 연구를 시행하였다. 면역조직학적 염색은 survivin은 rabbit antihuman polyclonal antibody를 이용하여 시행하였다. 결과: 골반강 외 자궁내막증에서 survivin의 발현은 선세포와 기질세포에서 핵내 발현은 정상자궁내막보다 증가하며 통계학적 차이를 보였다. 그러나 세포질 내 발현은 오히려 정상자궁내막이 통계학적 차이를 보이며 증가하였다. 난소 자궁내막종에서 survivin의 발현은 선세포와 기질세포에서 핵내 발현은 정상자궁내막보다 의미 있게 증가하나, 선세포와 정상자궁내막의 증 식기 비교에서는 통계학적 차이를 보이지 않았다. 세포질 내 발현은 정상자궁내막이 통계학적 차이를 보이며 증가하였다. 골반강 외 자궁내막증과 난소자궁내막증에서 survivin의 발현의 차이는 없었다. 결론: 골반강 외 자궁내막증 환자에서 세포고사를 저해하는 survivin의 발현이 증가하는 것은 survivin이 골반강 외 자궁내막증 의 병태 생리와 관련이 있을 것으로 생각된다.
Abstract
Objective: To examine survivin expression in extrapelvic endometriosis. Methods: The study group consisted of 14 cases with extrapelvic endometriosis which were confirmed histologically. The control group (total, n=47) was divided into 2 groups. Group I included normal endometrium (n=34) obtained from hysterectomy specimens with myoma and without endometriosis. Group II included ovarian endometrioma (n=13) obtained from laparoscopy. Expression of survivin was immunohistochemically confirmed. Results: In extrapelvic endometriosis, the expression of nucleus in glandular epithelium and stromal cells were significantly stronger than normal endometrium. But cytoplasm expression of glandular epithelial cells and stromal cells in extrapelvic endometriosis showed statistically lower in comparison with normal endometrium. In ovarian endometrioma, the expression of nucleus in glandular epithelial cells and stromal cells was significantly stronger than normal endometrium. But the expression of nucleus in glandular epithelial cells with ovarian endometrioma was stronger than during proliferative phase but was not significant. Also cytoplasm expression of ovarian endometrioma was lower than normal endometrium. There was no difference in survivin expression between extrapelvic endometriosis and ovarian endometrioma. Conclusions: In extrapelvic endometriosis, survivin expression was stronger than normal endometrium except cytoplasm. Our findings suggest that increased survivin expression may contribute to survival of extrapelvic implants.
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