不明原因复发性流产患者子宫内膜/早孕蜕膜组织HOXA-10基因的表达

Expression of HOXA-10 in the endometria/early pregnant decidua of unexplained recurrent spontaneous abortion women

目的探讨不明原因复发性流产(URSA)与子宫内膜/早孕蜕膜组织HOXA-10基因表达的关系。方法采用原位杂交技术,以HOXA-10反义核苷酸为探针检测51例URSA患者及38例正常生育(NF)组的分泌期子宫内膜/早孕蜕膜组织HOXA-10 mRNA的表达水平,并以灰度阳性单位(PU值)表示。结果NF组子宫内膜分泌早期HOXA-10mRNA表达的PU值腺体为(6.66±0.11),间质为(6.76±0.15);分泌中期分别为(10.95±0.90)及(11.46±1.08);分泌晚期分别为(11.05±1.12)及(11.54±1.10);蜕膜组织分别为(11.55±1.14)及(11.93±1.92);分泌中晚期及蜕膜组织的PU值显著高于分泌早期。URSA组不同时期子宫内膜及早孕蜕膜组织中HOXA-10 mRNA的表达水平基本一致,无明显的分泌中晚期及早孕期峰,并且分泌中晚期及早孕蜕膜组织的PU值明显低于NF同期组。两组各期腺体和间质的PU值无显著差异。结论子宫内膜HOXA-10基因在分泌中晚期及早孕蜕膜组织中的高表达可能和孕卵着床及妊娠维持密切相关,其表达缺陷可能是导致URSA发生的重要原因之一。

Objective： To study cyclic expression of HOXA-10 in normal and unexplained recurrent spontaneous abortion （URSA） women to explore its possible role in URSA. Methods： HOXA-10 mRNAs in the endometria / early pregnant deciduas of 51 URSA women and 38 normal fertile women were detected by in situ hybridization, and expressed as positive unit （PU）. Results： In the URSA group, PUs of HOXA-10 mRNA in early-, mid-, late-secretory endometria and early pregnant deciduas remained roughly constant （6.58±0.50, 6.69±0.47, 6.70±0.29 and 6.60±0.61 in glandular cells; 6.16±0.45, 6.04±0.57, 6.09±0.88 and 6.20±0.19 in stromal/decidual cells, respectively）. In the normal fertile （NF） group, PUs of HOXA-10 mRNA in early-secretory endometria were significantly lower than those in mid-, late-secretory endometria or pregnant deciduas （6. 66±0.11 vs. 10.95±0.90, 11.05±1.12 and 11.55±1.14 in glandular cells; 6.76±0.15 vs 11.46±1.08, 11.54±1.10 and 11.93±1.92 in stromal/decidual cells, respectively P〈0.05）. All PUs of URSA group, except for that in early secretory phase, were significantly lower than those of NF group both in endo-metria and deciduas. Conclusion： The higher expression of HOXA-10 mRNA in mid-, late-secretory endometria and deciduas is associated with implantation, decidualization and pregnancy. Its defective expression may alter development of endometrium and lead to abortion.