干细胞在妇产科领域的研究进展

Recent research on stem cells in obstetrics and gynaecology

目的:介绍干细胞在妇产科领域中的最新研究及应用进展。资料来源:应用计算机检索Medline1996-01/2006-12与干细胞在妇产科中的研究及应用相关的文章,检索词为“stem cell,gene therapy in the uterus,ovarian cancer,hysterocarcinoma”,限定文献语种为“English”;同时检索万方数据库2000-01/2006-12相关文章,检索词为“干细胞,宫内治疗,卵巢癌,子宫癌”,限定文献语种为中文。资料选择:共检索到相关文献180余条,选择干细胞在宫内治疗、生殖器官再造、辅助治疗以及妇科肿瘤方面的文章,无论观察对象是人还是动物均纳入,筛除明显重复和综述文献。资料提炼:将筛选的文献进一步查找全文,纳入30条文献进行综述。其中15篇论述干细胞在生殖器官再造方面的研究,7篇关于产科领域的研究进展,另外8篇是介绍干细胞在生殖医学和妇科肿瘤方面的应用。资料综合:①干细胞的发现和研究,为宫内治疗开辟了条新途径。目前进行宫内基因治疗的方法主要有两种:一是将作为靶细胞的干细胞,在体外进行转染后再输入受体胎儿体内,即间接法;另一种是直接将带有目的基因的载体注入到受体胎儿体内,在体内转染干细胞、表达外源基因而达到治疗目的,即直接法。②干细胞在生殖器官再造、男性不育治疗和保存生育能力等生殖医学领域的研究也取得了重大进展。③干细胞对妇科肿瘤的早期诊断有重要截止,如宫颈上皮干细胞中DNA含量和DNA异倍体的检出对早期识别细胞癌变及判断预后有重要意义。另外干细胞介入妇科恶性肿瘤的基因治疗有着无可比拟的优势,而且干细胞还可用于妇科恶性肿瘤的免疫治疗以及化疗或放疗所致的组织损伤的修复。结论:干细胞在妇产科应用广泛,特别是在器官再造、宫内治疗、辅助治疗以及妇科肿瘤等方面有很好的临床应用前景。

OBJECTIVE： To introduce the latest research and development of stem cells in gynaecology and obstetncs. DATA SOURCES： The Medline Database was undertaken to identify the articles on research and application of stem cells in gynaecology and obstetrics published from January 1996 to December 2006 with the key words of ＂stem cell, gene therapy in the uterus, ovarian cancer, hysterocarcinoma＂ in English. Simultaneously, Wanfang Database was searched for relevant articles published between January 2000 and December 2006 with the same key words in Chinese. STUDY SELECTION： Totally 180 relevant articles were retrieved, and articles on application of stem cells in therapy in the uterus, reconstruction of reproductive organ, adjunctive therapy and tumor of gynecology were selected. No matter human or animals were involved, and .hose with obviously repetitive and review were excluded. DATA EXTRACTION： Full-text of selected articles were checked, and 30 were included for review. Of them, 15 articles were on reconstruction of reproductive organ, 7 articles on development of obstetncs and 8 articles on application of stem cells in reproductive medicine and tumor of gynecology. DATA SYNTHESIS： （1）Development and research of stem cells develop a new approach of therapy in the uterus. Currently, there are two kinds of gene therapy methods in the uterus. One, stem cells as target cells infused in foetus after transfection in vitro, namely indirect method; another, carder with target gene are directly infused in foetus, and stem cells transfect and exogenous genes express in vivo, namely direct method. （2）There is greatly progress in application of stem cells in the circle of reproductive medicine, such as reconstruction of reproductive organ, therapy of male sterility, keeping fertility and so on. （3）Stem cells are important for the early diagnosis of tumor in gynecology, for example DNA content and DNA heteroploid in stem cells of epithelium of cervix are significant for cell cancerization and prognosis in an early period. In addition, it is unexampled to intervene gene therapy of malignant tumor in gynecology, and stem cells are also used in immunotherapy, repair of tissue damage due to chemical therapy or radiotherapy of malignant tumor in gynecology. CONCLUSION： Stem cells are widely used in gynaecology and obstetrics and have prospective application in clinic, especially reconstruction of reproductive organ, gene therapy in the uterus, adjunctive therapy, tumor of gynecology and so on.