MUM1/CD138双染在不孕症合并慢性子宫内膜炎病理诊断中的表达情况分析  

Analysis on the expression of MUM1/CD138 double staining in the pathological diagnosis of the infertility complicated with chronic endometritis

作　　者：李军红 赵朋月 魏素姣 王芳 LI Junhong;ZHAO Pengyue;WEI Sujiao;WANG Fang(Department of Pathologyy,Luoyang,Henan 471000,China;Department of Reproductive Medicine,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang,Henan 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院病理科,河南洛阳471000 [2]郑州大学附属洛阳中心医院生殖医学科,河南洛阳471000

出　　处：《现代医药卫生》2022年第10期1634-1638,共5页Journal of Modern Medicine & Health

基　　金：2020年河南省医学科技攻关计划联合共建项目(LHGJ20200864)。

摘　　要：目的探讨免疫组织化学多发性骨髓瘤致癌蛋白1(MUM1)/多配体蛋白聚糖-1(CD138)双染在不孕症合并慢性子宫内膜炎(CE)患者诊疗中的应用价值。方法选取2019年1-12月因不孕症在该院行宫腔镜子宫内膜诊刮术的活检标本567份,依据苏木素-伊红(HE)染色和免疫组织化学MUM1/CD138双染查见浆细胞作为病理诊断CE的方法,比较2种方法对CE的诊断率;选取其中借助人工辅助生殖技术(病理诊断为CE的患者均进行1个疗程的一线药物治疗)且有随访结果的患者278例,依据妊娠结局分为妊娠组(183例)和非妊娠组(95例),比较2组患者浆细胞计数结果。结果567份标本中HE染色诊断CE 217例(诊断率为38.3%),MUM1/CD138双染诊断CE 354例(诊断率为62.4%),MUM1/CD138双染诊断率明显高于HE染色,差异有统计学意义(P<0.05)。278例患者中妊娠183例(65.8%),MUM1/CD138双染浆细胞计数为6(1,30)个/20高倍镜(HPF);278例患者中非妊娠95例(34.2%),MUM1/CD138双染浆细胞计数为0(0,5)个/20 HPF,妊娠组患者MUM1/CD138双染浆细胞计数明显高于非妊娠组,差异有统计学意义(P<0.05)。结论MUM1/CD138双染能显著提高诊刮标本中不孕症患者CE诊断率;一线药物治疗对浆细胞计数大于或等于5个/20 HPF的CE患者更有效,能明显改善其生殖预后。Objective To investigate the value of immunohistochemical multiplemyeloma oncogene protein l(MUM1)/the transmembrane heparan sulfate proteoglycan syndecan-1(CD138)double staining in the diagnosis and treatment of the infertility patients complicated with chronic endometritis(CE).Methods A total of 567 biopsy specimens of endometrium diagnosed and curetted by hysteroscopy because of infertility were selected from January to December 2019.The diagnostic rate of CE was compared between the two methods based on the hematoxylin-eosin staining(HE)and MUM1/CD138 double staining.Among them,a total of 278 patients having follow-up results who received the artificial assisted reproductive technology(all patients with pathological diagnosis of CE received 1 course of first-line drug treatment)were selected.According to their pregnancy outcomes,the patients were divided into the pregnant group(n=183)and non-pregnant group(n=95).The plasma cell count results of the two groups were compared.Results Among the 567 specimens,a total of 217 cases(38.3%)were diagnosed with HE staining,and 354 cases(62.4%)were diagnosed with MUM1/CD138 double staining.The diagnostic rate of MUM1/CD138 double staining was significantly higher than that of HE staining,and the difference was statistically significant(P<0.05).Among the 278 patients,183(65.8%)were pregnant,and the MUM1/CD138 double-stained plasma cell count was 6(1,30)cells/20 high power(HPF).Among the 278 patients,95(34.2%)were non-pregnant,and the count of MUM1/CD138 double-stained plasma cells was 0(0,5)cells/20 HPF.The count of MUM1/CD138 double-stained plasma cells in the pregnant group was significantly higher than that in the non-pregnant group,the difference was statistically significant(P<0.05).Conclusion MUM1/CD138 double staining can significantly improve the diagnosis rate of CE in the infertile patients.First-line drug therapy is more effective in the CE patients with plasma cell count≥5 cells/20 HPF.It can significantly improve their reproductive prognosis.

关 键 词：MUM1/CD138双染 不育 慢性病 子宫内膜炎 浆细胞 病理学 

分 类 号：R365[医药卫生—病理学] R711.6[医药卫生—基础医学]