巨噬细胞极化调控宫腔粘连子宫内膜组织中CD68、CD163和VEGF的表达及临床意义

Macrophage polarization regulates the expression of CD68,CD163 and VEGF in endometrial tissue of uterine adhesion and its clinical significance

目的巨噬细胞是一群表型和功能均具有高度异质性的免疫细胞,其贯穿整个组织修复过程。在一定条件下,表现出不同表型和功能分化的现象称为巨噬细胞极化,可转化成M1型巨噬细胞(经典激活的巨噬细胞)和M2型巨噬细胞(选择性激活的巨噬细胞)。本文主要研究巨噬细胞的极化是否参与在宫腔粘连的子宫内膜修复过程。方法选择2020年至2021年在本院生殖中心行IVF治疗,移植失败一次及以上的患者对照组、实验组宫腔粘连轻度组、宫腔粘连中度组,移植失败一次及以上的患者,行宫腔镜下子宫内膜搔刮术,宫腔粘连各组同时行宫腔镜下宫腔粘连松解术,子宫内膜组织行CD68、CD163、VEGF免疫组化。结果流产清宫次数在三组中存在显著性差异(P<0.05),三组在年龄、BMI、不孕时间、分娩次数、异位妊娠次数方面无显著差异(P>0.05)。对照组CD68阳性率为93.3%(28/30),CD163阳性率为33.3%(11/30),VEGF阳性率为3.3%(1/30)。宫腔粘连轻度组CD68阳性率为53.3%(16/30),CD163阳性率为46.7%(14/30),VEGF阳性率为23.3%(7/30)。宫腔粘连中度组CD68阳性率为3.3%(1/30),CD163阳性率为96.7%(29/30),VEGF阳性率为100%(30/30)。相关性分析结果显示三组均存在显著性差异(P<0.05)。结论宫腔粘连的子宫内膜组织中,巨噬细胞发生极化,并促使VEGF等细胞因子形成一个动态的变化,促排组织的修复再生。

Objective Macrophages are a group of immune cells with high heterogeneity in phenotype and function,which run through the entire tissue repair process.Under certain conditions,phenomena that exhibit different phenotypes and functional differentiation are called macrophage polarization and can be converted into M1 macrophages(classically activated macrophages)and M2 macrophages(selectively activated macrophages).The main study of this paper was whether the polarization of macrophages was involved in the repair of the endometrium in the uterine cavity.Methods From 2020 to 2021,patients with uterine adhesion treated by IVF were selected in the reproductive center of our hospital.The patients transplanted failure once or more were involved into the control group.The patients with mild uterine adhesion and moderate uterine adhesion were involved into experimental group.The patients who failed transplantation once or more(control group)were underwent hysteroscopic endometrial scraping.The patients with mild uterine adhesion and moderate uterine adhesion were underwent intrauterine adhesiolysis under hysteroscopic.CD68,CD163 and VEGF of endometrial tissue were detected by immunohistochemistry.Results There was a significant difference in the number of miscarriage in the three groups(P<0.05).There was no significant difference in age,BMI,infertility time,delivery times and ectopic pregnancy times among the three groups(P>0.05).The positive rate of CD68 in the control group was 93.3%(28/30),the positive rate of CD163 was 33.3%(11/30),and the positive rate of VEGF was 3.3%(1/30).The positive rate for CD68 in the mild group of hysterical adhesions was 53.3%(16/30),the positive rate for CD163 was 46.7%(14/30),and the positive rate for VEGF was 23.3%(7/30).The positive rate for CD68 in the moderate group of hysterical adhesions was 3.3%(1/30),the positive rate for CD163 was 96.7%(29/30),and the positive rate for VEGF was 100%(30/30).The correlation analysis results showed significant differences between the three groups(P<0.05).Conclusion In the endometrial tissue adhered to the uterine cavity,macrophages are polarized,and a dynamic change is promoted by cytokines such as VEGF,which promotes the repair and regeneration of the tissue.