绝经后女性盆底脏器脱垂患者阴道前壁组织中层粘连蛋白、胶原蛋白及雌激素受体的表达

Expression of laminin,collagen and estrogen receptor in the anterior vaginal wall tissues of post-menopallsal female patients with pelvic organ prolapse

目的研究绝经后女性盆底脏器脱垂患者阴道前壁组织中层粘连蛋白(LN)、胶原蛋白及雌激素受体(ER)的表达。方法选择2016年1月至2018年12月于上海市嘉定区妇幼保健院因绝经后盆底脏器脱垂行阴式全子宫切除术+阴道壁修补术的40例患者作为观察组;另选择同期因其他子宫良性病变行阴式子宫全切术的40例患者作为对照组。术前采用酶联免疫吸附试验检测2组患者血清LN水平;术中取2组患者阴道前壁组织,采用荧光定量聚合酶链反应法检测LN mRNA表达,采用免疫组织化学法检测LN、胶原蛋白Ⅰ、胶原蛋白Ⅲ及ER表达。结果术前,观察组与对照组患者血清LN水平比较差异无统计学意义(P>0.05)。观察组患者阴道前壁组织中LN mRNA的相对表达量显著低于对照组(P<0.05)。观察组和对照组患者阴道前壁组织中LN阳性表达率分别为12.5%(5/40)、27.5%(11/40),观察组患者阴道前壁组织中LN阳性表达率显著低于对照组(χ2=45.262,P<0.01)。观察组患者阴道前壁组织中胶原蛋白Ⅰ、胶原蛋白Ⅲ及ER表达评分均显著低于对照组(P<0.05)。结论LN、胶原蛋白Ⅰ、胶原蛋白Ⅲ及ER在绝经后女性盆底脏器脱垂患者阴道前壁组织中的表达降低,推测绝经后女性盆底脏器脱垂与以上因素有关。

Objective To investigate the expression of laminin(LN),collagen and estrogen receptor(ER)in the anterior vaginal wall tissues of postmenopausal female patients with pelvic organ prolapse.Methods Forty postmenopausal female patients with pelvic organ prolapse who underwent transvaginal hysterectomy and repair of vaginal wall in the Maternal and Child Health Care Hospital of Jiading District of shanghai from January 2016 to December 2018 were selected as the observation group.Another 40 patients who underwent transvaginal hysterectomy due to other kind of benign uterine lesions were selected as the control group in the same period.Serum LN levels of patients in the two groups were measured by enzyme linked immunosorbent assay before operation.During the operation,the anterior vaginal wall tissues of patients in the two groups were taken and the expression of LN mRNA was detected by fluorescence quantitative polymerase chain reaction;the expressions of LN,collagenⅠ,collagenⅢand ER were detected by immunohistochemistry.Results There was no significant difference in the serum level of LN between the observation group and the control group before surgery(P>0.05).The relative expression of LN mRNA in the anterior vagina wall tissues of patients in the observation group was significantly lower than that in the control group(P<0.05).The positive expression rates of LN in the anterior vagina wall tissues of patients in the observation group and the control group were 12.5%(5/40)and 27.5%(11/40),respectively;the positive expression rate of LN in the anterior vagina wall tissues of patients in the observation group was significantly lower than that in the control group(P<0.05).The expression scores of collagenⅠ,collagenⅢand ER in the anterior vaginal wall tissues of patients in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The expressions of LN,collagenⅠ,collagenⅢand ER in the anterior vaginal wall tissues of postmenopausal women with pelvic floor prolapse are lower.It may be the etiological factors of postmenopausal women with pelvic floor prolapse.