子宫内膜息肉不孕症患者子宫内膜组织VEGF、Ki-67表达临床意义

Clinical significance of the vascular endothelial growth factor and Ki-67 expressions in endometrial tissue of infertility patients with endometrial polyps

目的:探究子宫内膜息肉不孕症患者息肉组织血管内皮生长因子(VEGF)、Ki-67表达临床意义。方法:收集2019年6月-2021年1月本院经宫腔镜确诊子宫内膜息肉不孕症患者90例为观察组,根据息肉病史分为息肉初发、复发,根据子宫内膜周期变化分为增殖期、种植窗期;非子宫内膜息肉不孕症患者45例为对照组。收集观察组息肉及周围组织、对照组内膜组织行VEGF、Ki-67免疫组化检测和相对表达量分析。结果:增殖期,观察组初发和复发息肉组织中VEGF(62.5%、73.3%)、Ki-67(75.0%、83.3%)蛋白阳性率及相对表达水平均高于周围组织及对照组(25.0%、41.7%)(均P<0.05);种植窗期,观察组VEGF表达阳性率(28.6%)低于对照组(80.9%)(P<0.05),Ki-67阳性率观察组(10.7%)与对照组(4.8%)无差异(P>0.05)。结论:在增殖期内膜息肉组织中VEGF、Ki-67异常高表达,可能参与了子宫内膜息肉的形成与复发。在种植窗期VEGF低表达可能导致子宫内膜容受性变差引发不孕症。

Objective:To explore the clinical significance of the expressions of vascular endothelial growth factor(VEGF)and Ki-67 in endometrial tissue of the infertility patients with endometrial polyps.Methods:90 infertility patients with endometrial polyps diagnosed by hysteroscope from June 2019 to January 2021 were collected in observation group.According to the history of polyps,these patients had included original onset of polyps and recurrence of polyps.According to the different situations of the endometrium,these patients were divided into group A(patients with proliferation period of the endometrium)and group B(patients with the implantation window period of the endometrium).45 infertility patients without endometrial polyp were collected in control group.The polyps and surrounding tissues of the patients in the observation group and the endometrial tissue of the patients in the control group were collected for the VEGF and Ki-67 levels detected by immunohistochemical.The relative expressions of the VEGF and Ki-67 levels were analyzed.Results:The positive rates of VEGF protein in original onset of polyps tissues and recurrence of polyps tissues of the patients during proliferation period of the endometrium were 62.5%and 73.3%,and the positive rates of Ki-67 protein in original onset of polyps tissues and recurrence of polyps tissues of the patients in the observation group during proliferation period of the endometrium were 75.0%and 83.3%,which were all significantly higher than those in the surrounding tissues of polyps tissues of the patients in the observation group or those in the endometrial tissue tissues of the patients in the control group.The relative expression levels of VEGF protein and Ki-67 protein in original onset of polyps tissues and recurrence of polyps tissues of the patients in the observation group during proliferation period of the endometrium were significantly higher than those in the surrounding tissues of polyps of the patients in the observation group or those in the endometrial tissue of the patients in the control group(all P<0.05).In implantation window period of the endometrium,the positive rate(28.6%)of VEGF expression of the patients in the observation group was significantly lower than that(80.9%)of the patients in the control group(P<0.05),but there was no significant difference in the positive rate of ki-67 expression(10.7%vs.4.8%)of the patients between the observation group and the control group(P>0.05).Conclusion:In the proliferation period of the endometrium,the VEGF and Ki-67 expression levels of the patients are abnormally increase,which may be involved in the formation and recurrence of endometrial polyps.The low expression level of VEGF of the patients in the implantation window may be related to the poor endometrial receptivity,which can lead to infertility.