檢測人類子宮內膜異位症的典型鈣粘蛋白並與子宮腔內之子宮內膜作一比較; IDENTIFICATION OF THE CLASSICAL CADHERIN SUBTYPES PRESENT IN THE HUMAN ENDOMETRIOSIS AND IN COMPARISON WITH THE EUTOPIC ENDOMETRIUM

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Title:	檢測人類子宮內膜異位症的典型鈣粘蛋白並與子宮腔內之子宮內膜作一比較;IDENTIFICATION OF THE CLASSICAL CADHERIN SUBTYPES PRESENT IN THE HUMAN ENDOMETRIOSIS AND IN COMPARISON WITH THE EUTOPIC ENDOMETRIUM
Authors:	戴金道;Chin-Tao Tai
Contributors:	中國醫藥學院醫學研究所
Keywords:	子宮內膜異位症;鈣粘蛋白;反轉錄聚合酉每連鎖反應;endometriosis;cadherin;reverse transcription-polpolymerase chain reaction
Date:	1990
Issue Date:	2009-12-03 09:27:17 (UTC+8)
Abstract:	背景子宮內膜異位症(endometriosis)是指子宮內膜的腺體及其基質出現在子宮腔外，在生育年齡的婦女其發生率將近3~10%，然而在不孕症的婦女，其發生率則高到25~35%。子宮內膜異位症造成的骨盆腔疼痛及不孕等症狀，是病人及醫療的極大負擔。至目前為止，其致病的機轉尚未明瞭，最被廣為接受的理論為經血逆流所造成，然而逆流的子宮內膜組織如何附著並侵入腹膜並得以增殖和成長，仍然是一個謎。鈣粘蛋白(cadherin)是一種細胞沾粘分子[cell adhesion molecules (CAM)]，其功能為細胞沾粘作用，同時在胚胎發育中主導不同組織及器官的形成，同時它們與癌細胞的侵襲性也有關。因此我們認為鈣粘蛋白可能與子宮內膜異位症的形成、侵入、及成長有關。本論文乃探討子宮內膜異位症中鈣粘蛋白的表現，並分析它們與子宮腔內之子宮內膜(eutopic endometrium)的不同表現，以瞭解子宮內膜異位形成的沾粘機轉(adhesive mechanism)。方法收集九位子宮內膜異位症的病人，依其月經週期分為增殖期(n=5)及分泌期(n=4)。首先利用degenerate reverse transcription-polymerase chain reaction (RT-PCR) 來檢測子宮內膜異位組織中典型鈣粘蛋白(classical cadherin)的種類。之後，再以semiquantitative RT-PCR的方法，比較同一病人其子宮內膜異位組織與子宮腔內之子宮內膜組織中，這些鈣粘蛋白mRNA的表現差異。結果我們確認子宮內膜異位組織中有六種典型鈣粘蛋白存在，它們分別為Epithelial-cadherin(E-cad)、Placental-cadherin(P-cad)、Neural-cadherin(N-cad)、cadherin-6、cadherin-9、和cadherin-11。比較這六種鈣粘蛋白在子宮腔內之子宮內膜與子宮內膜異位的表現差異時，我們發現P-cad mRNA表現在子宮內膜異位組織中較子宮腔內之子宮內膜組織有明顯增多。這種表現差異不論是增殖期或是分泌期都相同。結論我們確認六種典型鈣粘蛋白在子宮內膜異位組織。其中只有P-cad在子宮內膜異位組織中比子宮腔內之子宮內膜高出許多。因此，我們認為P-cad可能在子宮內膜異位症的形成之沾粘機轉中扮演著重要的角色。; Endometriosis is defined as the ectopic location of endometrium-like glandular epithelium and stroma outside the uterine cavity. Although it affects 3-10 % of women of reproductive age and 25-35 % of patients with infertility and pelvic pain, the cell biology of the pathogenesis of this disease is poorly understood. However, implantation of retrograde menstruation is widely accepted. In order to study the adhesive mechanism of the development of endometriosis, we have investigated the cadherin profile in endometriosis by using degenerate reverse transcription-polymerase chain reaction (RT-PCR) and six cadherin subtypes, E-cadherin, P-cadherin, N-cadherin, cadherin-6, cadherin-9, and cadherin-11, were identified. In addition, we have compared the messenger RNA (mRNA) levels of these cadherin subtypes in eutopic endometrium and endometriosis of the same patient by using semiquantitative RT-PCR. Of these cadherin subtypes, P-cadherin mRNA levels in endometriotic lesions were significantly greater than those observed in the corresponding eutopic endometrium during both proliferative and secretary phases of the menstrual cycle. In conclusion, P-cadherin is over-expressed in endometriotic tissues, which might play a key role in the development and maintenance of the endometriosis.
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