妊娠高血压综合征患者子宫螺旋动脉平滑肌细胞增生与c-myc基因表达的相关性研究

The Study on Correlation of c-myc Expression with Vascular Smooth Muscle Cell Proliferation in Uterine Spiral Arteries of Pregnancy Induced Hypertension

目的 探讨妊娠高血压综合征 (妊高征 )患者子宫螺旋动脉平滑肌细胞 (VSMC)增生与原癌基因c myc表达的关系。方法 应用原位杂交方法对 2 0例血压正常妊娠妇女、11例中度妊高征和 18例重度妊高征患者子宫螺旋动脉VSMC的c myc基因进行检测 ,同时观察子宫螺旋动脉平滑肌层的组织结构变化。结果 中度和重度妊高征患者VSMCc myc的阳性表达率分别为 6 3.6 % (7/ 11)和 72 .2 % (13/ 18) ,明显高于正常妊娠妇女的 2 5 .0 % (5 / 2 0 ,P <0 .0 5 ) ;而中、重度妊高征患者子宫螺旋动脉VSMC的增生率分别为 5 4.5 % (6 / 11)和 5 5 .6 % (10 / 18) ,明显高于正常妊娠妇女的 10 .0 % (2 / 2 0 ,P <0 .0 5 )。相关分析显示 ,c myc的高表达同VSMC增生相关。结论 妊高征患者子宫螺旋动脉的c myc高表达 ,能导致VSMC的增生 ,并可能是引发妊高征一系列病理变化的环节之一。

Objective To investigate c myc proto oncogene expression of uterine spiral arteries in pregnancy induced hypertension (PIH) and the relationship of this expression with vascular smooth muscle cell (VSMC) proliferation in uterine spiral arteries of PIH. Methods Forty nine placental bed biopsies, 29 from women with PIH and 20 from normotensive pregnant women, were taken during cesarean section. The expression of c myc in uterine spiral arteries was detected and localized by in situ hybridization. Histological changes of placental bed biopsies were evaluated by HE staining. Results The positive rate of c myc was 63.6% (7/11) in moderate PIH and 72.2% (13/18)in severe PIH respectively. They were significantly higher than that in normotensive pregnancy ( P <0.05, P <0.01, Fisher exact test). 54.5% (6/11) of moderate PIH and 55.6% (10/18) of severe PIH had VSMC proliferation. This was only 10.0% (2/20) in normotensive pregnancy. It was significantly lower than those of moderate and severe PIH ( P <0.05, P <0.005, Fisher exact test). In PIH cases the VSMC proliferation in uterine spiral arteries was correlated with higher c myc expression (chi square test, P =0.009 3). Conclusion c myc expression is higher in VSMC of uterine spiral arteries in PIH. VSMC Proloferates obviously in uterine spiral arteries of PIH cases. VSMC proliferation in PIH may be associated with c myc expression.