不明原因复发性自然流产患者分泌期子宫内膜树突状细胞数量分析  

Quantitative analysis of uterine dendritic cells in secretory phase of women with unexplained recurrent spontaneous abortion

作　　者：徐士儒 刘苏 李玉叶 陈聪 林嘉音 曾勇 Xu Shiru, Liu Su, Li Yuye, Chen Cong, Lin Jiayin, Zeng Yong(Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen Key Laboratory of Reproductive Immunology for Periimplantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, China （Xu SR, Liu S, Li YE, Chen C, Lin JY, Zeng Y)

机构地区：[1]深圳中山泌尿外科医院生殖中心,深圳市围着床期生殖免疫重点实验室,深圳中山生殖与遗传研究所,518045

出　　处：《中华生殖与避孕杂志》2018年第2期89-95,共7页Chinese Journal of Reproduction and Contraception

基　　金：深圳市科技计划项目(JCYJ20170307140647669); 深圳市卫生计生系统科研项目(201606063)~~

摘　　要：目的研究子宫内膜树突状细胞(DC)在不明原因复发性自然流产(uRSA)患者分泌期子宫内膜的表达情况。方法根据子宫内膜形态学Noyes标准,对在本中心就诊的uRSA患者(uRSA组,n=113)与男性因素不孕患者(对照组,n=35)进行子宫内膜分期;以CD1_a与CD83分别作为子宫内膜未成熟树突状细胞(iDC)与成熟树突状细胞(m DC)的表面标志物,并利用免疫组织化学技术检测患者分泌期子宫内膜CD1_a与CD83阳性细胞的数量,并通过Vectra~?自动病理成像定量分析系统分别计算其阳性细胞率。结果 uRSA组分泌期子宫内膜CD1_a阳性细胞率无明显变化,而CD83阳性细胞率[(2.03±1.60)%]显著高于对照组[(0.81±1.11)%,P=0.000];两组患者子宫内膜CD1_a阳性细胞率从分泌早期到中期均呈递减趋势,而CD83阳性细胞率从分泌早期到中期均呈递增趋势;与对照组相比,uRSA组子宫内膜CD1_a阳性细胞率在分泌早期和中期均无明显变化,而uRSA组子宫内膜CD83阳性细胞率在分泌早期[(1.64±1.20)%]和中期[(2.20±1.60)%]均显著高于对照组[(0.17±0.11)%,P=0.000;(0.63±0.78)%,P=0.000]。结论 uRSA组患者子宫内膜分泌早期和中期CD83阳性细胞率异常升高,提示其可能影响子宫内膜容受性,从而导致妊娠失败。Objective To explore the uterine dendritic cell（uDC） levels in the secretory phase of patients with unexplained recurrent spontaneous abortion（uRSA）. Methods The expression of CD1 a and CD83 in the endometrium of women with uRSA（113 cases） and infertility women with male factors（35 cases） were detected by immunohistochemical staining technique. The percentages of CD1 a＋ and CD83＋ cells were measured by Vestra？ automatic pathological imaging quantitative analysis system. Results There was no significant difference in the proportion of CD1 a＋ cells in the secretory phase of patients with uRSA and control group. However, the percentage of CD83＋ cells in the secretory phase of patients with uRSA [（2.03±1.60）%] was significantly higher than that in control group [（0.81±1.11）%, P=0.000]. In addition, the percentages of CD83＋ cells during early-[（1.64±1.20）%] and mid-secretory phase [（2.20±1.60）%] from uRSA group were significantly higher than those in control group [（0.17±0.11）%, P=0.000;（0.63±0.78）%, P=0.000, respectively]. The percentage of CD1 a＋ cells was gradually decreased through the early-and mid-secretory phase in both groups, while the percentage of CD83＋ cells was gradually increased. Conclusion The abnormal elevation of uterine CD83＋ cells in early-and mid-secretory phase of patients with uRSA may affect the endometrial receptivity, which may lead to pregnancy failure.

关 键 词：不明原因复发性自然流产(uRSA) 子宫内膜树突状细胞(uDC) CD1A CD83 

分 类 号：R714.21[医药卫生—妇产科学]