通过测定瘦素(leptin)和瘦素受体(leptin receptor，Ob-R)在卵巢子宫内膜异位症(endometriosis, EMs)患者异位内膜及在位内膜中的表达，探讨瘦素系统在子宫内膜异位症发生发展中的作用及意义。

收集2008年7月至11月，在本院因卵巢子宫内膜异位症行腹腔镜手术的25例患者的异位内膜和在位内膜为研究对象，分别纳入A组和B组。收集同期在本院因子宫肌瘤行腹腔镜手术的24例患者的正常内膜组织，纳入对照组。对研究组和对照组患者的子宫内膜组织，分别采用免疫组化SP法检测瘦素和瘦素受体水平(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书)。A，B组和对照组患者年龄、体重指数(body mass index，BMI)、末次月经及内膜组织学Noyes分期等比较，差异无显著意义(P>0.05)。

瘦素和瘦素受体在B组、A组和对照组子宫内膜腺体及间质内，均可见阳性表达。瘦素在A组腺体的表达，明显高于间质，且差异有显著意义(P<0.05)。瘦素在A组、B组和对照组的表达比较，差异无显著意义(P>0.05)，但瘦素在A组间质的表达，低于对照组和B组，且差异有显著意义(P<0.05)。瘦素受体在A组腺体和间质的表达比较，差异无显著意义(P>0.05)；瘦素受体在A组腺体的表达，低于B组和对照组，差异有显著意义(P<0.05)；而其表达在间质比较，则差别无显著意义(P>0.05)。瘦素在B组增生期腺体和间质的表达，高于分泌期，但差异无显著意义(P>0.05)；而瘦素在对照组增生期腺体和间质的表达，高于分泌期，且差异有显著意义(P<0.05)；瘦素受体在B组和对照组增生期和分泌期表达比较，差异均无显著意义(P>0.05，P>0.05)。

瘦素和瘦素受体在卵巢内膜异位症异位内膜中的低表达，表明瘦素系统在卵巢异位病灶发展过程中的作用有限。

To study the expression of leptin and leptin receptor (Ob-R)in ectopic and eutopic endometrium from women with ovarian endometriosis(EMs), and to explore their role in pathogenesis of ovarian endometriosis.

Twenty-five subjects with surgically confirmed ovarian endometriosis were chosen for study in the West China Second University Hospital of Sichuan University from July to November 2008. Expression of leptin and leptin receptor in the ectopic endometrium (group A)and eutopic endometrium (group B) of endometriosis was detected by immunohistochemical SP method. Meanwhile, 24 subjects with uterus myoma were chosen as control group. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital, Sichuan University. Informed consent was obtained from all participants.

Leptin and leptin receptor were localized in intracytoplasm of glandular epithelial cells and stromal cells in the ectopic and eutopic endometrium of endometriosis and in the normal endometrium of control group. The expression of leptin in the glandular epithelial cells of group A was statistically higher than that in the stromal cells (P<0.05). There was no difference of leptin expression in the glandular epithelial cells among group A, B and control groups (P>0.05), but the expression of leptin in the stroma cells of group A was statistically lower than that in group B and control groups (P<0.05); There was no difference of leptin receptor expression between the glandular epithelial cells and stromal cells of group A (P>0.05). The expression of leptin receptor in the glandular epithelial cells of group A was statistically lower than that in group B and control groups (P<0.05), but there was no difference in stroma cells (P>0.05). In group B, the expression of leptin in the glandular epithelial cells and stromal cells in proliferative phase was higher than that in secretory phase, but there was no statistical significance (P>0.05); meanwhile, the expression of leptin in both glandular epithelial cells and stromal cells of the proliferative phase of control group were statistically higher than those in the secretory phase (P<0.05). There was no statistical difference of the expression of leptin receptor in group A and control groups, either proliferative phase or secretory phase (P>0.05).

The lower expression of leptin and leptin receptor in the ectopic endometrium of ovarian endometriosis indicates that the role of leptin and leptin receptor in the pathogenesis of ovarian endometriosis is limited.