IUGR的胎盘病理改变及胎盘EGFR免疫组化分析

ANALYSES OF PATHOLOGICAL CHANGES AND EGFR EXPRESSIONS IN IUGR PLACENTAS

目的观察IUGR的胎盘病理改变及EGFR表达情况,探讨IUGR的发病机制。方法选取患IUGR的妊娠妇女18例及正常妊娠妇女25例,对其胎盘组织行常规HE染色及EGFR(表皮生长因子受体)免疫组化分析,观察胎盘形态学变化及EGFR表达情况。结果 IUGR组绒毛间质纤维化及纤维素样坏死>3%,合体滋养细胞结节>30%,绒毛血管减少、闭塞的数量均明显高于对照组(P<0.01)。IUGR者EGFR的表达显著高于对照组(P<0.05)。结论 IUGR的胎盘病理改变主要有三方面:IUGR组绒毛间质纤维化及纤维素样坏死,合体滋养细胞结节,绒毛血管减少、闭塞。以上改变致胎盘交换面积减少,限制了营养物质的摄取和转运,是造成IUGR胎盘功能减退的形态学基础。IUGR胎盘上EGFR表达增加可能与其胎盘绒毛发育不良有关,提示EGF在胎儿胎盘的生长发育过程中及IUGR的病理过程中起重要作用。

Objective To observe the pathological change of placenta in patients of intrauterine growth retardation （IUGR） and the expressions of （epidermal growth factor receptor ）EGFR and to explore the pathogenesis of IUGR. Methods Placental samples were collected from 18 pregnancies of IUGR and from 25 normal pregnant woman. The tissue sections were assessed for morphological change with HE-stain section and analyzed by EGFR immunohistochemical technique. Results The number of stroma fibrosis and fibrinoid necrosis of villi was more than 3 %, and the number of villous syncytial knots was more than 30 %. The numbers of the decrease of chorio- angioma and obstruction were significantly higher in the group of IUGR than those of the control group（ P 〈 0.01）.EGFR expression rate was higher in IUGR group than in control group（ P 〈0.05）. Conclusion The pathological changes of IUGR include three aspects： interstitial fibrosis and fibrinoid necrosis, zoarium tropho- blasts, decreased chorioangioma. All of the above results in the decrease of placental area, and the intake and transportation of nutrition are restricted, which is the morphological base that leads to the hypofunction of placenta. The increase oflUGR EGFR expressions was perhaps related to dysplasia of placental villus. EGFR may have an important effect on infant growth and IUGR pathological process.