早孕绒毛组织中HOXA7、9、10基因的表达及米非司酮对其的影响

Expression Level of Homeobox(HOX)Gene in Early Pregnant Chorion with Different Doses of Mifepristone

目的:探讨米非司酮抗早孕的作用机理。方法:因非意愿妊娠要求终止妊娠的正常早孕妇女60例,分为3组,分别为常规负压吸宫对照组、负压吸引术前服用米非司酮100mg组和150mg,每组20例。运用RT-PCR及免疫组织化学方法检测各组绒毛组织中HOXA7、9、10mRNA和蛋白的表达。结果:①正常早孕绒毛组织在mRNA和蛋白水平均可见HOXA7、9、10基因的表达,表达主要在滋养细胞胞质,间质少量表达。②不同剂量的米非司酮均可以降低绒毛组织中HOXA7、9、10mRNA及蛋白的表达量,但对不同基因的降表达程度有所不同。150mg米非司酮对早孕绒毛组织中HOXA7、10基因的降表达作用明显大于100mg米非司酮(P<0.01)。服用不同剂量米非司酮后的早孕绒毛组织中HOXA7、9、10蛋白的表达位置仍以滋养细胞胞质为主,间质少量表达。结论:HOXA7、9、10基因表达于正常早孕绒毛组织中,服用米非司酮后可降低其表达,呈一定的剂量依赖性,但未改变蛋白的表达位置。米非司酮的抗早孕作用可能是通过对绒毛组织中HOXA7、9、10基因的调控来达到的,且以150mg的米非司酮作用明显。

Objective：To explore the mechanism of mifepristone in terminating early pregnancy. Methods：RT-PCR was used to detect the expressions of HOXA7,9,10 mRNA in 60 cases after induced abortion with and without mifepristone（0 mg mifepristone for 20 cases,100 mg mifepristone for 20 cases,150 mg for 20 cases）;and the IHC was performed to analyze the subcellular distribution and quantity of HOXA7,9,10 protein in part samples（0 mg mifepristone for 6 cases,100 mg mifepristone for 12 cases,150 mg for 12 cases）.Results：HOXA7, 9,10 genes were expressed in early pregnant chorion,which mostly exist in trophoblastic cytoplasms and thimblefully expressed in interstitial cells.Mifepristone could decrease the expressions of HOXA7 and HOXA10 genes,and the effect of 150 mg mifepristone on them were more significantly（P〈0.01）.Mifepristone could decrease the expres-sion of HOXA9 gene without statistic significance（P〉0.05）.Conclusions：The early pregnant chorion could express HOXA7,9,10 genes.And mifepristone could decrease the expressions of them,which might play a role in the process of adherence and implantation in embryo.So 150 mg mifepristone may be the better choice for clinical medical abortion.