胎盘组织中人类主要组织相容性抗原G mRNA的表达变化与特发性胎儿生长受限发病的关系

Placental expression of human histocompatibility antigen-G mRNA in idiopathic fetal growth restriction and its relationship with pathological changes of placenta

目的探讨人类主要组织相容性抗原G(HLA G) mRNA在特发性胎儿生长受限(IFGR)产妇胎盘组织中的表达及其与IFGR发病的关系。方法采用原位杂交法,检测20例IFGR产妇(IFGR组)及28例正常产妇(对照组)胎盘组织中HLA GmRNA的表达水平和表达部位,并对两组产妇的胎盘组织进行病理学观察。结果( 1 )IFGR组产妇胎盘出现病理改变的发生率为75%(15 /20), 主要为慢性绒毛膜炎、胎盘梗死及绒毛发育迟缓;明显高于对照组的18% (5 /28),两组比较,差异有统计学意义(P=0 001)。(2)IFGR组产妇胎盘HLA GmRNA的阳性表达率为45% ( 9 /20),明显低于对照组的79% ( 22 /28 )。两组比较,差异有统计学意义(P= 0 017 )。( 3 )HLA GmRNA的阳性表达部位主要位于胎盘绒毛外细胞滋养细胞及合体滋养细胞的细胞质内,呈紫蓝色的颗粒状沉淀,轮廓清晰。(4)HLA GmRNA表达阴性者,出现胎盘病理改变的例数较HLA GmRNA表达阳性者明显增多(r=-0 638,P=0 008 )。结论IFGR产妇胎盘组织中HLA GmRNA表达水平明显下降,HLA GmRNA的异常表达可能参与了IFGR的发病过程。

Objective To investigate the expressions of human histocompatibility antigen-G (HLA-G) mRNA in placenta of idiopathic fetal growth restriction (IFGR) and its relationship with pathogenesis of IFGR. Methods In situ hybridization was used to investigate the expression level and distribution of HLA-G mRNA in placentas of 20 cases of idiopathic IFGR and 28 cases of control group. HE stain was applied to observe the pathological changes of the placenta. Results (1) The incidence of placental pathological lesions in idiopathic IFGR (75%) was notably higher than those of the control group (18%), (χ2=15.67, P=0.001). (2) In situ hybridization showed the positive expression rate of HLA-G mRNA in placenta of idiopathic IFGR was 45%, that of control group was 79%, with significant difference between the two groups (χ2=5.75,P=0.017). HLA-G mRNA signal mainly expressed in cytotrophoblast and syncytiotrophoblast. (3) There was negative correlation between the expression rate of HLA-G mRNA and incidence of placental pathological lesions (r=-0.638, P=0.008). Conclusions There is a significant decrease in the expression of HLA-G mRNA in IFGR. HLA-G may play a role in the pathogenesis of IFGR.