자궁선근종에서 bcl-2와 MMP-9의 면역화학적 발현을통한 병인론에 관한 연구
The Pathogenesis of Adenomyosis Through the Immunohistochemical Studywith bcl-2 and MMP-9
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목적 : bcl-2와 matrix metalloproteinase-9 (MMP-9)에 대한 항체 발현 정도를 비교하여 자궁선근종의 병인론에 대해 연구하고자 하였다. 연구 방법 : 자궁의 양성 질환으로 적출한 자궁조직 중 자궁선근종으로 진단이 된 45예에 대하여 면역화학적 염색을 실시하였다. 염색에 이용한 항체는 bcl-2와 MMP-9 이였으며, 염색의 정도와 범위를 정성적으로 판단하였다. 결과 : 45예의 자궁조직 중에 증식기의 조직이 32예였고, 분비기의 조직이 13예였다. 증식기 자궁근층의 선조직은 bcl-2가 81.3% 발현되었으며, MMP-9은 6.3% 발현이 있었다 (p<.001). 분비기에서는 각각 92.3%, 7.7%였다 (p<.001). 증식기의 기질조직에서는 bcl-2 발현이 62.5%였고 MMP-9발현은 6.3%였으며 (p<.001), 분비기에서는 각각 84.6%, 15.4%였다 (p<.001). 결론 : 자궁선근종의 발생은 자궁내막 조직의 단순 함입에 의해 발생하는 것으로 여겨지며, 자궁내막 조직의 침습에 의한 것은 아닌 것으로 보인다.
Abstract
Objective : To understand the pathogenesis of adenomyosis through the immunohistochemical staining with bcl-2 and matrix metalloproteinase-9 (MMP-9) antibody. Methods : We selected 45 cases of adenomyosis among the uterine specimens that were extirpated surgically due to benign gynecologic problem. Immunohistochemical staining to the myometrial tissue was performed using anti-bcl-2 and anti-MMP-9 antibodies. Staining was qualitatively assessed in terms of extent and intensity. Results : There were 32 cases of proliferative phase and 13 cases of secretory phase depending on the date of endometrium. Anti-bcl-2 stained 81.3% (26/32) compared with anti-MMP-9 stained 6.3% (2/32) in the glandular tissue of the proliferative phase (p<.001). In the secretory phase, anti-bcl-2 92.3% (12/13) and anti- MMP-9 7.7% (1/13) respectively (p<.001). In the stromal tissue of the proliferative phase, anti-bcl-2 stained 62.5% (20/32) compared with anti- MMP-9 stained 6.3% (2/32) (p<.001). In the secetory phase, anti-bcl-2 84.6% (11/13) and anti-MMP-9 15.4% (2/13) (p<.001). Conclusion : The adenomyosis may be developed from simple invagination and cellular proliferation of endometrial tissue, not caused by myometrial infiltration of endometrial tissue.
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