乙状结肠代阴道成形术后阴道黏膜细胞形态及闭锁蛋白、带状闭合蛋白1表达的变化  

Expression of occludin and zona occluden-I and their morphologic changes in vagina mucosal cells in patients undergoing vaginal construction by using sigmoid colon

作　　者：黄向华[1] 张琳[1] 高志敏[1] 朱志洁[1] 

机构地区：[1]河北医科大学第二医院妇产科,石家庄050000

出　　处：《中华妇产科杂志》2009年第8期588-592,共5页Chinese Journal of Obstetrics and Gynecology

基　　金：基金项目：河北省卫生厅指导性项目（07201）

摘　　要：目的观察乙状结肠代阴道成形术后，阴道局部黏膜细胞的形态变化及闭锁蛋白、带状闭合蛋白1（ZO．1）的表达变化，对阴道局部防御功能的影响。方法应用光镜、电镜及免疫组化链霉菌抗生物素蛋白一过氧化物酶连接（sP）法，对15例乙状结肠代阴道成形术后黏膜（研究组）及15例正常乙状结肠黏膜（对照组）的活检标本进行形态学观察，并对黏膜细胞中闭锁蛋白及ZO一1的表达进行了半定量分析。结果（1）研究组10例（67％）阴道下段黏膜发生鳞状上皮化生。（2）电镜下见成形术后阴道黏膜上皮细胞间紧密连接变得短而宽，数量减少或消失。（3）研究组阴道上段黏膜细胞中，闭锁蛋白的阳性表达率为80％（12／15），ZO一1的阳性表达率为73％（11／15），研究组阴道下段已发生鳞状上皮化生的黏膜细胞中闭锁蛋白和ZO一1的阳性表达率均为100％（10／10），对照组也均为100％（15／15），分别与阴道上段黏膜细胞比较，差异均有统计学意义（P〈0．05，P〈0．01）。研究组阴道下段未发生鳞状l：皮化生的黏膜细胞中闭锁蛋白和ZO一1的阳性表达率（4／5、2／5）低于已发生鳞状上皮化生者（均为100％，10／10）及对照组[均为100％（15／15）]，差异也有统计学意义（P〈0．05）；而与其上段黏膜细胞比较，差异尤统计学意义（P〉0．05）。在成形术后阴道下段鳞状上皮化生的黏膜细胞中，两种蛋白的阳性表达率与对照组比较，差异无统计学意义（P〉0．05）。结论乙状结肠代阴道成形术后，部分阴道下段黏膜发生了鳞状上皮化生；成形术后阴道上段及下段未发生鳞状上皮化生的黏膜细胞中，闭锁蛋白及ZO．1阳性表达率下降；化生的鳞状上皮细胞中，两种蛋白的表达与原位的乙状结肠黏膜相似，可能对加强人工阴道的防御功能起到了一定作用。Objective In order to evaluate the changes of neovaginal defense function in the sight of physical barrier by investigating the changes in the histological morphology and expression of occludin, zona occluden-1 （ZO-1） in mucosal cells of the neovagina in patients undergoing vaginal construction by sigmoid colon. Methods Fifteen cases with neovagina constructed by sigmoid colon matched with 15 cases＇ vaginal mocusa as control specimens were observed with light microscopic and electron microscopic methods. At the same time, the expression of occludin and ZO-1 were semiquantitatively measured by streptavidin-perosidase （SP） immunohistochemical method. Results （1） Squamous metaplasia was observed in colonic mucosa from lower one-third of the artificial vagina in I0 cases （67%, 10/15）. （2） The intercellular tight junctions of neovaginal mucosa became shorter and wider, the number of them were decreased or disappeared by electron microscopic study. （3） In upper neovagina, the positive rates of occludin and ZO-1 expression in mueosal cells were 80% （ 12/15 ） and 73% （ 11/15 ） , respectively. In lower neovaginal mucosa where squamous metaplasia occurred, the positive rates of two protein expression in cells were both 100% （10/10）and also was 100% （ 15/15 ） in control group, which showed significant difference （ P 〈 0. 05, P 〈 0. 01 ）. In lower neovaginal mucosa where squamous metaplasia hadn＇t occurred, the positive expression of two protein in cells （4/5, 2/5 ） were significantly lower than those in lower neovaginal mucosa where squamous metaplasia had happened 100% （10/10）, 100% （10/10） and in control group [ 100% （15/15）, 100% （15/15） ] （P〈0. 05）,while there were no significantly difference in positive expression of two protein in cells between this group and upper neovagina （ P 〉 0. 05 ）. Conclusions The squamous metaplasia had occurred in lower neovaginal mucosa. The decreased expression of occludin and ZO-1 in upper and lower neovag

关 键 词：阴道 黏膜 紧密连接部 膜蛋白质类 磷蛋白类 

分 类 号：R686[医药卫生—骨科学]