子宫腺肌病患者子宫肌层平滑肌细胞生长状态与增殖特点的研究

Study on the growth and proliferation characteristics of uterine smooth muscle cells in patients with adenomyosis

目的观察子宫腺肌病(Adenomyosis,ADS)子宫与正常子宫不同解剖部位平滑肌细胞生长与增殖状态的差异。方法收集2014年6月至2015年6月于首都医科大学附属北京妇产医院妇科微创中心因ADS行子宫切除的标本14例为ADS组,选取同期因宫颈上皮内瘤变(cervical intraepithelial neoplasias,CIN)Ⅲ或早期宫颈癌切除的子宫标本15例为对照组。原代培养子宫内膜-肌层交界区(endometrialmyometrial interface,EMI区)与子宫外周肌层(outer myometrium,OM)平滑肌细胞,显微镜下观察细胞形态特性,采用CCK8法检测细胞生长活力,流式细胞术检测细胞周期,分析细胞增殖情况。结果 1子宫EMI区与OM平滑肌细胞形态有明显差异,EMI区细胞多呈长梭形,OM细胞多呈菱形且倾向于成簇生长;EMI区细胞"峰-谷"特点和结节形成现象比OM细胞显著。2 ADS组EMI区细胞生长旺盛,高于ADS组OM细胞和对照组EMI区细胞的生长活力。3 ADS组在EMI区的平滑肌细胞G2+S期比例为24.35%±2.51%,高于OM区细胞比例(21.04%±1.27%),EMI区细胞增殖能力比OM区显著增强(P<0.05);EMI区平滑肌细胞在ADS组的G2+S期比例为24.35%±2.51%,高于对照组细胞(20.72%±1.28%)(P<0.05)。结论ADS患者EMI区细胞生长状态和增殖能力旺盛,可能是影响腺肌病发生发展的形态学基础。

Objective To compare the growth and proliferation characteristics of smooth muscle cells in different position of uterine with adenomyosis （ADS） and normal uterine. Methods 14 myometrium specimens were obtained sterilely from patients with ADS who underwent hysterectomy in Beijing Obstetrics and Gynecology Hospital affiliated of Capital Medical University from June 2014 to June 2015 ,and they were set as ADS group. 15 specimens from patients with cervical intraepithelial neoplasias （CIN） Ⅲ or early stage cervical cancer during the same time were set as control group. Smooth muscle ceils of endometrial -myometrial interface （EMI） and outer myometrium （OM） were cultured and observed by microscopy. Cell viability was detected by CCKS. Cell cycle was assayed with flow cytometry to analyze cell proliferation condition. Results ① There was a big difference between the morphological features of EMI and OM cells. EMI smooth muscle ceils were mostly long spindle shaped. However, OM cells tended to be rhomboidal shaped and crowed together. The ＂hill and valley＂ phenomenon was more obvious in EMI than OM. ②Growth vitality of EMI smooth muscle cells in ADS group was more vigorous than that of OM cells in ADS group and that of EMI cells in control group. ③ G2 ＋ S stage cell ratio of EMI smooth muscle cells [ （24. 35 ±2. 51 ）% ] was higher than that of OM cells in ADS gToup [ （21. 04 ± 1. 27）% ] （P 〈 0. 05 ）. Cell proliferate ability of EMI was significantly higher than that of OM. G2 ＋ S stage cell ratio of EMI in ADS group was higher than that of control group [ （20. 72% ±1.28 ） % ] （ P 〈 0. 05 ）. Conclusions Vigorous growth vitality and strong proliferation ability of EMI smooth muscle cells may influence the genesis and development of adenomyosis.