巨噬细胞集落刺激因子与肿瘤坏死因子在早发型重度子痫前期胎盘组织中的表达及临床意义

Expression and significance of TNF-αand M-CSF in placenta tissue of early severe preeclampsia

目的探讨巨噬细胞集落刺激因子(macrophage colony-stimulating factor,M-CSF)和肿瘤坏死因子(tumor necrosis factor,TNF-α)在早发型重度子痫前期(preeclampsia,PE)胎盘中的表达及临床意义。方法采用免疫组织化学SP法检测2015年9月至2017年9月在河南科技大学第一附属医院病理科的石蜡标本77例PE,其中早发型重度PE 35例、晚发型重度PE 42例和正常孕妇30例胎盘组织中M-CSF和TNF-α的表达。结果(1)M-CSF在对照组、晚发重度PE组、早发重度PE中的阳性表达率分别为30%(9/30)、61.90%(26/42)、82.86%(29/35),差异有统计学意义(χ2=18.90,P<0.05),且早发重度PE阳性表达较对照组显著增高(χ^2=18.59,P<0.05),差异有统计学意义;早发重度PE组阳性表达比晚发重度PE组高,差异有统计学意义(χ^2=4.017,P<0.05);(2)TNF-α在对照组、晚发重度PE组、早发重度PE中的阳性表达率分别为33.33%(10/30)、69.05%(29/42)、91.43%(32/35),差异有统计学意义(χ^2=30.21,P<0.05),且早发重度PE阳性表达较对照组显著增高(χ^2=21.37,P<0.05),差异有统计学意义;早发重度PE组阳性表达比晚发重度PE组高,差异有统计学意义(χ^2=4.529,P<0.05);(3)在PE中M-CSF和TNF-α的表达呈正相关(r=0.441,P=0.000)。结论早发型重度PE中胎盘损害较高,且与疾病的严重程度相关;PE患者胎盘组织中M-CSF和TNF-α水平在PE的发生发展中可能起协同作用。

Objective To investigate the expression and clinical significance of macrophage colony stimulating factor(M-CSF)and tumor necrosis factorα(TNF-α)in placenta of early onset severe preeclampsia(PE).Methods Immunohistochemical SP method was used to detect the expression of M-CSF and TNF-αin 77 cases paraffin specimens from Department of Pathology,First Affiliated Hospital of Henan University of Science and Technology from September 2015 to September 2017,including 35 cases of early-onset severe PE,42 cases of late-onset severe PE and 30 cases of normal pregnant women.Results(1)The positive expression rates of M-CSF in control group,late-onset severe PE group and early-onset severe PE group were 30%(9/30),61.90%(26/42),82.86%(29/35),respectively.The difference was statistically significant(χ^2=18.90,P<0.05).The positive expression rates of early-onset severe PE group were significantly higher than those in control group(χ^2=18.59,P<0.05),and the difference was statistically significant..The positive expression of early-onset severe PE group was higher than that of late-onset severe PE group,and the difference was statistically significant(χ^2=4.017,P<0.05).(2)The positive expression rates of TNF-αin control group,late-onset severe PE group and early-onset severe PE group were 33.33%(10/30),69.05%(29/42),91.43%(32/35),respectively.The difference was statistically significant(χ^2=30.21,P<0.05).The positive expression of TNF-αin early-onset severe PE group was significantly higher than that in control group(χ^2=21.37,P<0.05),and the difference was statistically significant.The positive expression of M-CSF and TNF-a in early-onset severe PE group was higher than that in late-onset severe PE group,and the difference was statistically significant(χ^2=4.529,P<0.05);(3)The expression of M-CSF and TNF-αwas positively correlated in PE(r=0.441,P=0.000).Conclusion Placental damage is higher in early-onset severe PE,and is related to the severity of the disease.The levels of M-CSF and TNF-alpha in placenta of PE patients may play a synergistic role in the occurrence and development of PE.