Objectives

Epithelial-Mesenchymal Transition (EMT), a cellular process in which epithelial cells lose epithelial characteristics while acquire mesenchymal features, is believed to contribute to migration and invasion abilities of the endometriotic cells. Studies on gene expression of the transcription factor ZEB1, a crucial transcription factor of EMT, show that there is probably a modified expression in the endometriotic lesions.

The aim of the study was to compare the expression levels of ZEB1 in types of endometriotic lesions with different biological behavior such as endometriomas and deep infiltrating endometriotic nodules.

Study Design

We have studied 19 patients with endometriosis and 8 patients with benign gynecological lesions without endometriosis.

The endometriosis patient group included 9 women with only endometriotic cysts without deep infiltrating endometriotic lesion (DIE) and 10 women with DIE who had developed concurrent endometriotic cysts.

The technique applied to investigate ZEB1 expression levels is Real-Time PCR. The results of the reaction were normalized by simultaneously investigating the expression of the house-keeping gene G6PD.

Results

Analysis of the samples showed underexpression of ZEB1 in the eutopic endometrium of women with only endometriotic cysts when compared to normal endometrium. A tendency of higher ZEB1 expression, without reaching significant difference, was found between the endometriotic cysts and their paired eutopic endometrium.

In women with DIE, no significant difference was found between their eutopic and normal endometrium. No significant difference was found between the endometriomas and DIE lesions.

ZEB1 shows different expression profile in the endometriotic cysts of women with and without DIE when the cyst is compared to their paired eutopic endometrium.

Conclusions

It therefore appears that ZEB1 expression differs between different types of endometriosis. The expression levels of ZEB1 in the eutopic endometrium could affect the development of infiltrating lesions or not. However, the most important observation is the different ZEB1 expression profile of endometriomas between women with and without DIE. Although, they both share the same histologic characteristics, they show different ZEB1 expression indicating different pathogenetic mechanisms of endometriomas in cases with and without DIE. Therefore, future research on endometriosis should consider DIE and ovarian endometriosis as different diseases.

中文翻译：

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ZEB1 在不同形式的子宫内膜异位症中的表达：一项初步研究

目标

上皮-间充质转化 (EMT) 是一种细胞过程，其中上皮细胞失去上皮特征，同时获得间充质特征，被认为有助于子宫内膜异位细胞的迁移和侵袭能力。对转录因子ZEB1（ EMT 的关键转录因子）的基因表达的研究表明，在子宫内膜异位病变中可能存在修饰的表达。

本研究的目的是比较ZEB1在子宫内膜异位症和深部浸润性子宫内膜异位结节等具有不同生物学行为的子宫内膜异位病灶类型中的表达水平。

学习规划

我们研究了 19 名子宫内膜异位症患者和 8 名没有子宫内膜异位症的良性妇科病变患者。

子宫内膜异位症患者组包括 9 名只有子宫内膜异位囊肿但没有深浸润性子宫内膜异位病变 (DIE) 的女性和 10 名患有 DIE 并发子宫内膜异位囊肿的女性。

用于研究ZEB1表达水平的技术是实时 PCR。通过同时研究管家基因G6PD的表达来标准化反应结果。

结果

样本分析显示，与正常子宫内膜相比，仅患有子宫内膜异位囊肿的女性在位子宫内膜中ZEB1表达不足。在子宫内膜异位囊肿及其配对的在位子宫内膜之间发现ZEB1表达较高的趋势，但没有达到显着差异。

在患有 DIE 的女性中，在位子宫内膜和正常子宫内膜之间没有发现显着差异。子宫内膜异位症和 DIE 病变之间没有发现显着差异。

当将囊肿与配对的在位子宫内膜进行比较时，ZEB1在患有和不患有 DIE 的女性的子宫内膜异位囊肿中显示出不同的表达谱。

结论

因此，不同类型的子宫内膜异位症之间的ZEB1表达似乎不同。ZEB1在在位子宫内膜中的表达水平可能影响浸润性病变的发生与否。然而，最重要的观察结果是患有和未患有 DIE 的女性在子宫内膜异位瘤中的ZEB1表达谱不同。虽然它们具有相同的组织学特征，但它们显示出不同的ZEB1表达，表明在有和没有 DIE 的情况下子宫内膜异位症的不同发病机制。因此，未来对子宫内膜异位症的研究应将 DIE 和卵巢子宫内膜异位症视为不同的疾病。