早期流产者绒毛和蜕膜组织中MMP-9、TIMP-3的表达及其意义

目的:了解MMP-9和TIMP-3在早孕、先兆流产和药物流产绒毛及蜕膜组织中的定位及表达水平,探讨其水平及平衡在维持正常妊娠中的作用。方法:选取90例早孕妇女作为研究对象,其中行负压吸宫术者30例为对照组,行药物流产术者30例为药物流产组;自愿行吸宫术的先兆流产妇女30例为先兆流产组,均留取绒毛和蜕膜组织,应用免疫组织化学技术和计算机图像分析系统检测MMP-9和TIMP-3在不同早孕流产绒毛和蜕膜组织中的表达。结果:MMP-9和TIMP-3在3组绒毛的合体滋养细胞、细胞滋养细胞、毛细血管内皮细胞的胞浆,蜕膜的蜕膜细胞、腺上皮细胞和血管内皮细胞的胞浆呈不同程度的阳性染色。通过定量分析,药物流产组绒毛和蜕膜MMP-9的表达高于先兆流产组,先兆流产组高于对照组(P<0.05);3组绒毛和蜕膜TIMP-3的表达差异无统计学意义(P>0.05)。绒毛和蜕膜中MMP-9/TIMP-3药物流产组高于先兆流产组,先兆流产组高于对照组(P<0.05)。结论:MMP-9表达水平的升高在流产发生过程中具有重要作用,MMP-9和TIMP-3的平衡对维持正常妊娠起重要作用。

Expression of MMP-9 and TIMP-3 at the Villus and Deciduous of Early Abortion and Its Significance

Objective:To study the localization and expression of MMP-9 and TIMP-3 at the villus and deciduous of the normal early pregnancy,threatened abortion and medical abortion,and the role of MMP-9/TIMP-3 for sustaining the normal early pregnancy.Methods:90 early pregnancy women without complications(menelipsis days less than 50 days) were collected,including 30 cases artificial abortion,30 cases threatened abortion and 30 cases medical abortion,and the expression of MMP-9 and TIMP-3 in the villus and deciduous of early pregnancy abortion were determined by immunohistochemistry technology and computer image analysis systems.Results:MMP-9 and TIMP-3 exhibited positive staining at the syneytiotrophoblast,cytotrophoblast and capillary endothelial cell of villus,decidual cell,glandular epithelium cell and vascular endothelial cell of deciduous.Through quantitative analysis,the expression of MMP-9 in the villus and deciduous of the medical abortion group was higher than that of the threatened abortion group,and the expression of MMP-9 of threatened abortion group was higher than that of the control group,and the differences were significant(P<0.05).There was no significant differences of the expression of TIMP-3 in the villus and deciduous among the three groups(P>0.05).To the ratio of MMP-9/TIMP-3 in the villus and deciduous,the medical abortion group was higher than the threatened abortion group and the threatened abortion group was higher than the control group,and the differences were significant(P<0.05).Conclusion:The higher expression of MMP-9 may play an important role in the process of abortion.It is also important to the balance of the expression of MMP-9 and TIMP-3 for sustaining the normal early pregnancy.