早孕期经宫颈细胞中寻找胎儿细胞及免疫细胞化学研究

Acqwisition of fetal cells from transcervcial cells in early pregnancy and immunocytochemiscal study

目的研究早孕妇女生殖道中胎儿细胞的存在情况,用免疫细胞化学法确证胎儿细胞来源,寻找无创或微创的产前诊断取材方法及时机。方法将健康早孕妇女宫颈取材标本分为两组:HE染色组(Ⅰ)和免疫细胞化学组(Ⅱ);选择通水术中输卵管通畅的健康妇女为对照,分为两组:HE染色组(Ⅲ)和免疫细胞化学组(Ⅳ)。无菌棉拭子术、宫颈粘液吸引术、宫颈管灌洗术和宫腔内灌洗术采集标本,HE染色和免疫细胞化学染色后观察滋养细胞存在情况。结果(1)早孕妇女经宫颈细胞中存在可代表胎儿细胞的滋养细胞;(2)宫颈管灌洗术和宫腔内灌洗术取材方法较好,获得胎儿细胞较多;(3)取材时机为妊娠50～79d。结论早孕妇女生殖道中存在胎儿细胞,在妊娠50～79d用宫颈灌洗术或宫腔内灌洗术取材,是一种较为安全有效的产前诊断技术。

Objective To study the presence of trophoblast cells in the lower uterus in early pregnancy, identify fetal cells by immunocytochemistry, and determine the best timing for sample collection. Methods Samples from healthy gravida in early pregnancy were divided into HE group （ Ⅰ ） and immunocytochemistry group （ Ⅱ ）, and those from healthy nonpregnant women were also divided into HE group （Ⅲ） and immunocytochemistry group （Ⅳ）. Four different methods （usage of a cotton swab, aspiration of the cervical mucus, lavage of the endocervical canal, and lavage of the intrauterine cavity） were employed for collecting the samples, which were tested with HE staining or immunocytochemistry, and the presence of fetal cells was observed under optical microscope. Results and Conclusion Fetal cells were detected in the genital tract of the gravida in early pregnancy. Utilization of the lavage of the endocervical canal or the lavage of the intrauterine cavity allowed greater amount of fetal cell acquisition, and sampling of the fetal cells between 50 days and 79 days of gestational age yielded optimal results. These sampling methods may provide safe and effective means for prenatal diagnosis with minimal invasiveness.