广西体外受精-胚胎移植不孕妇女子宫内膜和息肉组织整合素αvβ3表达初探

Primary study on integrin αvβ3 expressions in endometrium and endometrial polyps of infertile women treated by IVF- ET in Guangxi

目的:通过收集在广西壮族自治区人口和计划生育研究中心生殖科(广西生殖健康中心)行体外受精-胚胎移植(IVF-ET)不孕症妇女子宫内膜和息肉组织做病理切片苏木素-伊红(HE)染色和子宫内膜容受性分子整合素αvβ3免疫组织化学(免疫组化)染色,观察αvβ3表达分布情况,为研究提高子宫内膜息肉(EP)不孕症患者妊娠率提供参考依据。方法:在广西生殖健康中心收集30例确诊为EP不孕症并做IVF-ET患者的子宫内膜和息肉组织作为研究组,另取30例同期在该中心以丈夫不育为主因做IVF-ET的非EP患者(接近正常)子宫内膜组织作为正常对照组,同期在广西医科大学第一附属医院计划生育门诊收集30例非EP非不孕症的取环诊断性刮宫(诊刮)患者子宫内膜组织作为宫内节育器(IUD)避孕对照组(IUD避孕组),内膜和息肉由宫腔镜或诊刮获得,分别进行病理切片HE染色及整合素αvβ3免疫组化染色,以大肠癌组织作为阳性对照组(15例),以同种无关血清替代一抗作为阴性对照组(30例)。结果:整合素αvβ3免疫组化染色结果显示,阳性对照组腺上皮和间质细胞胞核、胞质均普遍强阳性表达;阴性对照组则基本无表达;正常对照组可见腺上皮胞质、胞核普遍阳性表达,间质细胞胞质普遍阳性表达而胞核基本不表达;IUD避孕组局部腺上皮阳性表达(胞质为主),间质细胞局部散在点状阳性表达;研究组内膜腺上皮胞质、胞核均强阳性表达,间质细胞胞质一般阳性表达而胞核不表达;研究组息肉组织腺上皮胞核、胞质基本不表达,间质局部散在小片状强阳性表达。与正常对照组比较,免疫组化染色半定量结果显示,IUD避孕组子宫内膜和研究组息肉αvβ3阳性染色区域(Area)和累积光密度(IOD)均显著降低,差异有统计学意义(P<0.05或P<0.01)。结论:广西IVF-ET的EP不孕患者子宫内膜及息肉组织整合素αvβ3免疫组化染色以间质局部散在小片状强阳性表达为主,腺上皮基本不表达,Area和IOD均显著降低。

Objective： To observe the expression and distribution of integfin αvβ3, provide reference for improving pregnancy rate of infertile patients with endometrial polyps by collecting HE staining sections of endometrium and endometrial polyps and immunohistochemi- cal staining of integrin αvβ3 in endometrium and endometrial polyps among infertile women treated by in vitro fertilization and embryo trans- fer （IVF-ET） in Department of Reproduction, Research Center for Population and Family Planning of Guangxi Zhuang Autonomous Region. Methods： The endometrium and endometrial polyps specimens of 30 infertile patients with endometrial polyps and treated by IVF-ET were collected from Reproductive Health Center of Guangxi as study group, at the same time, the endometrium specimens of 30 infertile patients because of male factor, without endometrial polyps, and treated by IVF-ET were selected as control group, the endometrium specimens of 30 patients without EP and infertility and receiving diagnostic curettage were selected during the same period as IUD control group, endometrium and endometrial polyps specimens were obtained by hysteroscopy or diagnostic curettage, HE staining of pathological section and immunohis- tochemical staining of integrin αvβ3 were conducted, colorectal cancer specimens of 15 patients were selected as positive control group, con- specific independent serum specimens were used to instead primary antibodies in 30 patients, then they were designed as negative control group. Results： Integrin αvβ3 immunohistochemical staining showed that integrinαvβ3 expressions in nuclei and plasma of glandular and interstitial cells in positive control group were strongly positive; integrin αvβ3 expression in negative control group was rare; integrin αvβ3 ex- pression in nuclei and plasma of glandular cells, plasma of interstitial cells were positive in normal control group; in IUD control group, inte- grin αvβ3 expressed positively in local glandular cells and local inter- spersed small region of interstitial cells; in study group, integrin αvβ3 expressed positively in nuclei and plasma of glandular cells and plasma of interstitial cells in endometrium; in study group, integrin αvβ3 ex- pressed positively in local interspersed small region of interstitial cells of endometrial polyps ; compared with normal control group, immuno- histochemieal staining showed that positive staining area （Area） and IOD of integrin αvβ3 in endometrium of IUD control group and endome- trial polyps of study group decreased significantly （P〈0. 05 orP〈0.0l ） . Conclusion： Immunohistochemical staining of integrin αvβ3 in endometrium and endometrial polyps of infertile women treated by IVF-ET in Guangxi are mainly displayed as positive local and interspersed small region of interstitial cells, integrin αvβ3 does not express in glandular cells, both Area and IOD decrease significantly.