子宫瘢痕中c-kit和PI3K的表达及与瘢痕愈合关系

Expressions of C-kit and PI3K in uterine scar tissue and its relationships with uterine scar healing

目的:探讨子宫瘢痕中干细胞因子受体(c-kit)和磷酸肌醇3激酶(PI3K)的表达及与子宫瘢痕愈合关系。方法:选取本院前次剖宫产术后再次妊娠孕妇110例为观察组,按照再次妊娠间隔时间分为<3年、3～<4年、4～<6年、6～<8年、≥8年,各组根据术中子宫瘢痕愈合情况分为良好组(87例)与不良组(23例)。另选取同期本院初次剖宫产孕妇25例为对照组。实时荧光定量PCR及免疫组化法检测各组子宫瘢痕组织中c-kit、PI3K的表达量,logistic法分析子宫瘢痕愈合的影响因素。结果:剖宫产术后<3年组、≥8年组孕妇瘢痕组织中c-kit、PI3K表达水平及阳性表达量均高于对照组,而3～<4年组表达最低,且子宫瘢痕愈合不良发生率也最低(P<0.05);子宫瘢痕愈合不良组c-kit、PI3K表达水平高于良好组(P<0.05);c-kit、PI3K表达水平均为影响子宫瘢痕愈合的危险因素。结论:子宫瘢痕组织中c-kit、PI3K表达水平升高并可促进子宫瘢痕愈合,但其过表达时不利于子宫瘢痕愈合,剖宫产术后3～4年是子宫瘢痕愈合的最佳时期。

Objective:To investigate the expressions of stem cell factor receptor (c kit) and phosphotyl inosital 3 kinase (PI3K) in uterine scar tissue,and to study their relationships with uterine scar healing.Methods:110 pregnant women underwent cesarean sections again were selected into the study group,and 25 pregnant women underwent cesarean section at the first time were selected into control group.The women in study group were also divided into group A (87 cases with healed well of uterine scar) and group B (23 cases with undesirable healing of uterine scar) according to the condition of uterine scar healing during cesarean section again.Real time fluorescent quantitative PCR (qRT PCR) and immunohistochemistry were used to detect the relative expressions of c kit and PI3K of all included women.The influencing factors of uterine scar healing were analyzed by Logistic analysis.Results:The expressions and the levels of of c kit and PI3K of women with history cesarean section <3 years or≥8 years were significant higher than those of women in control group (P <0.05).The rates and levels of positive expressions of c kit and PI3K expressions of women with undesirable healing of uterine scar after cesarean section after operation 3 4 years were the lowest (P < 0.05).And the levels of positive expressions of c kit and PI3K of women with undesirable healing of uterine scar were significant higher than those of women with healed well of uterine scar (P <0.05).Logistic analysis showed that the levels of c kit and PI3K were risk factors for uterine scar healing.Conclusion:The expression levels of c kit and PI3K in uterine scar tissue can promote uterine scar healing,but their over expressions are not benefit for uterine scar healing,3 4 years after cesarean section is the best period for uterine scar healing.