早期胚胎停育绒毛滋养层细胞病理学变化  

Pathological changes of placental villi trophoblastic cells in missed abortion

作　　者：朱旗 董艺超 张璐 马旭[1,2] 夏红飞 ZHU Qi;DONG Yi-chao;ZHANG Lu;MA Xu;XIA Hong-fei(Reproductive&Genetic Center,National Research Institute for Family Planning,Beijing 100081;Graduate School,Peking Union Medical College,Beijing 100730)

机构地区：[1]国家卫生健康委科学技术研究所遗传优生中心,北京100081 [2]北京协和医学院研究生院,北京100730

出　　处：《生殖医学杂志》2020年第1期85-91,共7页Journal of Reproductive Medicine

基　　金：国家自然科学基金(81771590);北京市自然科学基金(7172163)

摘　　要：目的观察早期胚胎停育(MA)胎盘绒毛滋养层细胞的病理学变化。方法选择2011年12月至2013年12月于河北石家庄第六医院门诊就诊的260例MA患者(孕周<12周)作为研究对象(MA组),选择该院自愿行人工流产的正常早孕孕妇(孕周<12周)作为对照组,共396例。取MA组及对照组患者的胎盘绒毛组织送至北京龙迈达科技公司制成组织阵列芯片,样本按≤25岁、26~30岁、31~34岁、≥35岁年龄区间分组,每组随机挑选10对(病例及对照)进行分析。采用免疫组化法检测反映胎盘血管发生的血管内皮生长因子(VEGF)、反映滋养层细胞和间质细胞分布情况的细胞角蛋白(CK19)和波形蛋白(Vimentin)在MA组和对照组患者早孕绒毛滋养层细胞中的表达差异;通过Tunel法检测MA组和对照组患者早孕绒毛滋养层细胞的凋亡情况。结果早期MA组绒毛滋养层细胞中VEGF表达量较对照组显著降低(P<0.01),而MA组绒毛滋养层细胞中CK19及Vimentin表达与对照组无统计学差异(P>0.05));MA组绒毛滋养层细胞的凋亡指数显著高于对照组(P<0.001)。结论胎盘绒毛滋养层细胞中VEGF的低表达及细胞凋亡指数的增加与胚胎停育发生密切相关,提示胎盘血管生成减少和滋养层细胞过度凋亡是造成早期胚胎停育的部分原因。Objective:To observe the pathological changes of placental villus trophoblastic cells in missed abortion(MA).Methods:A total of 260 patients with MA(pregnancy week<12 weeks)who were admitted to the outpatient clinic of Shijiazhuang No.6 Hospital in Hebei Province from December 2011 to December 2013 were selected as the study subjects,and 396 normal pregnant women with voluntary abortion were selected in this hospital(pregnancy week<12 weeks)as a control group.The placental villus tissues of the patients in the MA group and the control group were sent to Beijing Longmaida Technology Co.,Ltd.to make the tissue array chip.The samples were grouped according to the age range of≤25 years old,26-30 years old,31-34 years old,≥35 years old,ten pairs(cases and controls)of each group were randomly selected for analysis.The immunohistochemistry was used to determine the expression of vascular endothelial growth factor(VEGF),cytokeratin(CK19)and vimentin in placental villus trophoblastic cells.Apoptosis in placental villus trophoblastic cells was detected by Tunel method.Results:The expression of VEGF was significantly lower in MA trophoblastic cells compared with normal trophoblastic cells(P<0.01).There was no significant difference in the expression of CK19 and vimentin between MA trophoblastic cells and normal trophoblastic cells(P>0.05).The apoptotic index of trophoblast cells in MA placental villus was significantly higher than that in normal group(P<0.001).Conclusions:Low expression of VEGF and increase of apoptotic index in trophoblast cells are closely related to the occurrence of MA,indicating the reduction of placental angiogenesis and excessive apoptosis of trophoblast cells are part of the cause of MA.

关 键 词：胚胎停育 VEGF CK19 VIMENTIN 凋亡 

分 类 号：R714.2[医药卫生—妇产科学]