上皮细胞及间质细胞表面分子在兔子宫内膜中的表达

目的探讨兔子宫内膜中上皮细胞及间质细胞表面分子的表达。方法应用流式细胞术检测上皮细胞表面标记分子EpCAM、EMA，及间质细胞表面标记分子CD90（Thy-1）和Collagen type I，lit—PCR分析上述表面分子的mRNA表达，同时对Sox2及Oct4的mRNA进行检测。结果在兔子宫内膜中，可以检测到EpCAM、EMA、CD90及CollagentypeI的mRNA及蛋白表达，同时可检测到Oct4及Sox2在兔子宫内膜中的表达。结论兔子宫内膜可能存在上皮细胞及间质细胞两种细胞成分，同时可能存在兔子宫内膜干细胞。     

Clonal lineage from normal endometrium to ovarian clear cell carcinoma through ovarian endometriosis

Clear cell carcinoma of the ovary is thought to arise from endometriosis. In addition, retrograde menstruation of shed endometrium is considered the origin of endometriosis. However, little evidence supports cellular continuity from uterine endometrium to clear cell carcinoma through endometriosis at the genomic level. Here, we performed multiregional whole‐exome sequencing to clarify clonal relationships among uterine endometrium, ovarian endometriosis and ovarian clear cell carcinoma in a 56‐year‐old patient. Many somatic mutations including cancer‐associated gene mutations in ARID1A, ATM, CDH4, NRAS and PIK3CA were shared among epithelium samples from uterine endometrium, endometriotic lesions distant from and adjacent to the carcinoma, and the carcinoma. The mutant allele frequencies of shared mutations increased from uterine endometrium to distant endometriosis, adjacent endometriosis, and carcinoma. Although a splice site mutation of ARID1A was shared among the four epithelium samples, a frameshift insertion in ARID1A was shared by adjacent endometriosis and carcinoma samples, suggesting that the biallelic mutations triggered malignant transformation. Somatic copy number alterations, including loss of heterozygosity events at PIK3CA and ATM, were identified only in adjacent endometriosis and carcinoma, suggesting that mutant allele‐specific imbalance is another key factor driving malignant transformation. By reconstructing a clonal evolution tree based on the somatic mutations, we showed that the epithelium samples were derived from a single ancestral clone. Although the study was limited to a single patient, the results from this illustrative case could suggest the possibility that epithelial cells of ovarian endometriosis and clear cell carcinoma were descendants of uterine endometrial epithelium.     

Perivascular Stem Cell-Derived Cyclophilin A Improves Uterine Environment with Asherman’s Syndrome via HIF1α-Dependent Angiogenesis

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Premature expression of the decidualization marker prolactin is associated with repeated implantation failure

Abstract

Repeated implantation failure (RIF) is a poorly understood reproductive pathology defined by the inability to achieve a clinical pregnancy in at least three consecutive IVF cycles. In this study, we investigated whether the onset of decidualization, marked by prolactin (PRL) expression, is associated with RIF. We performed a retrospective cohort study using endometrial biopsies from women with idiopathic subfertility, that conceived naturally during the same cycle in which the biopsy was taken (group 1; n?=?15) conceived naturally within three months after the biopsy was taken (group 2; n?=?20), or unsuccessfully underwent six IUI cycles and three IVF cycles with transfer of at least one high-quality embryo (group 3, RIF; n?=?20). Our results demonstrated that immunohistochemical PRL-staining was present in 8/15 women from group 1 (53.3%), in 1/20 women from group 2 (5.0%), and in 11/20 women from group 3 (55.0%). Increased proliferation, analyzed by Ki67 expression, was seen in women that were pregnant during the biopsy, compared to all women combined that were not pregnant (p≤.01). In conclusion, our study demonstrates that premature expression of the decidualization marker PRL during the luteal phase is associated with RIF.     

经阴道彩色超声诊断子宫内膜癌34例分析

目的研究经阴道彩色超声(TVCDS)在子宫内膜癌中的声像图特征,探讨其在子宫内膜癌中的诊断价值。方法对经手术病理证实的34例子宫内膜癌患者TVCDS图像进行回顾性分析,得出其诊断符合率,并分析其超声图像特征。结果 34例患者TVCDS诊断为子宫内膜癌30例,诊断符合率为88.2%;诊断符合的30例超声图像特征主要为宫腔占位型(20例)、内膜增厚型(10例);血流显示21例,显示率70.0%;阻力指数(RI)0.31～0.56,Ia、Ib期与Ic～IV期比较,RI值差异具有统计学意义(P0.05)。结论经阴道彩色超声诊断子宫内膜癌符合率高,能为临床治疗提供可靠的信息。     

Endometrial metaplasia

Epithelial metaplasia refers to the replacement of normal epithelium at a given site by mature benign epithelium inappropriate to that site. The endometrium is not unique in that it too demonstrates a spectrum of metaplastic epithelia. Some of these cytoplasmic alterations are better termed “changes” as they are thought not to represent true metaplastic transformation of the endometrial epithelium. The terminology is rather confusing as these two terms have been used interchangeably in the literature. This process may be encountered in benign conditions but can also be seen in association with endometrial hyperplasia and adenocarcinoma. The presence of endometrial metaplasia can significantly complicate the histological interpretation of endometrial biopsy material due to glandular architectural complexity and crowding which can lead to an erroneous diagnosis of endometrial hyperplasia or even carcinoma if the pathologist is unaware of the potential pitfalls. Endometrial metaplasia although commonly seen involving endometrial epithelium, may also on occasions involve the stroma. This review will describe the spectrum of histological features that can be seen in endometrial metaplasia of both epithelium and stroma and will aim to emphasize those histopathological features that will be helpful in distinguishing endometrial metaplasia from hyperplasia and carcinoma.     

宫腔内灌注G-CSF对改善薄型子宫内膜临床疗效的系统评价与Meta分析

目的系统评价宫腔内灌注粒细胞集落刺激因子(G-CSF)对改善薄型子宫内膜的有效性,为临床应用G-CSF治疗薄型子宫内膜提供参考依据。方法计算机检索Pubmed、Embase、CNKI等中、英文数据库,系统搜集宫腔内灌注G-CSF治疗薄型子宫内膜的实验性和观察性研究,检索时限为从建库至2016年7月。由2位研究者独立地筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Revman 5.3软件进行Meta分析。结果最终纳入14篇文献,其中2个随机对照试验、5个非随机对照实验以及7个队列研究,共944例患者。Meta分析结果显示:与对照组比较,宫腔内灌注G-CSF可显著改善子宫内膜厚度[MD=1.43,95%CI(0.67,2.19),P=0.000 2]、提高临床妊娠率[RR=2.48,95%CI(1.37,4.51),P=0.003]和降低周期取消率[RR=0.44,95%CI(0.29,0.66),P0.000 1]。而在胚胎种植率方面,两组差异无统计学意义[RR=1.90,95%CI(0.99,3.67),P=0.05]。漏斗图显示发表偏倚存在的可能性较小。结论现有证据表明,经阴道宫腔内灌注G-CSF具有改善子宫内膜厚度、提高临床妊娠率和降低人工周期取消率等优势。但鉴于纳入研究数量和质量有限,上述结论仍应被谨慎对待,并有待更多高质量研究予以验证。     

Decreased expression of interleukin-37 in the ectopic and eutopic endometria of patients with adenomyosis

Previous studies have shown that alterations of cytokines might play a role in the pathogenesis of adenomyosis. This study aims to investigate the expression of interleukin-37 (IL-37), an anti-inflammatory cytokine, in the eutopic and ectopic endometria of patients with adenomyosis. Endometrial specimens were collected from 30 women with adenomyosis and 20 without adenomyosis. The gene and protein expression of IL-37 was measured using a quantitative real-time polymerase chain reaction and immunohistochemistry, respectively. Compared with the control endometria, the protein expression level and gene level of IL-37 was significantly lower in both the ectopic and eutopic endometria of patients with adenomyosis. The gene and protein expressions of IL-37 in ectopic endometria were lower than those in eutopic endometria of patients with adenomyosis. Our results suggest that there was a low level of IL-37 in the eutopic and ectopic endometria of patients with adenomyosis, and an abnormal inflammatory response might occur in the endometria of patients with adenomyosis.