雌、孕激素受体在反复移植失败伴慢性子宫内膜炎患者子宫内膜中的表达及意义

目的探讨雌、孕激素受体在子宫内膜中的表达与反复移植失败(RIF)的关系,并分析CD138免疫组化染色法检测对慢性子宫内膜炎(CE)的诊断意义。方法收集2018年1月至2019年6月就诊于兰州大学第一医院生殖医学中心的RIF患者80例(RIF组)和同期未接受过胚胎移植的不孕患者80例(对照组)的临床资料,分别对两组患者子宫内膜组织行CD138免疫组化染色,分析CE与RIF的关系。80例RIF患者中有34例检测雌激素受体(ER)和孕激素受体(PR);并根据是否患有CE再次分组,分为CE组(n=14)和非CE组(n=20),比较两组患者子宫内膜组织中ER和PR的表达情况。结果免疫组化染色发现,RIF组患者子宫内膜组织中的CD138阳性率为17.5%(14/80),对照组CD138阳性率2.5%(2/80),两组间比较有显著性差异(P<0.05)。CE组患者子宫内膜间质和腺体中ER的表达水平显著高于非CE组(P<0.05),而子宫内膜中间质及腺体中PR的表达水平在CE组与非CE组间比较无显著性差异(P>0.05)。结论CE与RIF有关,针对具有CE高危因素的患者可以选择CD138免疫组化染色进行检查。在临床工作中,对于CE患者,ER表达的检测可能有助于个性化激素治疗方案的选择。

Expression and significance of estrogen and progesterone receptors in endometrium of patients with repeated implantation failure and chronic endometritis

Objective:To explore the relationship between the expression of estrogen&progesterone receptor and repeated transplantation failures,and analyze the diagnostic significance of CD138 immunohistochemical staining for chronic endometritis(CE).Methods:The medical records of 80 patients with repeated implantation failure(RIF group)in the Reproductive Medicine Center of the First Hospital of Lanzhou University from January 2018 to June 2019 were retrospectively collected,and the clinical data of 80 infertile patients without embryo transfer in the same period as controls(control group).CD138 immunohistochemical staining was performed on the endometrial tissue of the patients of two groups.Among 80 RIF patients,the estrogen receptor(ER)and progesterone receptor(PR)were detected by immunohistochemistry in 34 patients.According to whether the patients suffered CE or not,they were divided into CE group(n=14)and non-CE group(n=20).Compare the expression of ER and PR in the endometrial tissue of the two groups.Results:The positive rate of CD138 immunohistochemical staining in the RIF group was 17.5%(14/80),which significantly higher than that in the control group(2.5%,2/80)(P<0.05).The ER expression level in the endometrial stroma and glands in CE group was significantly higher than that in the non-CE group(P<0.05),while the PR expression level was not significantly different between the two groups(P>0.05).Conclusions:RIF is related to CE.CD138 immunohistochemical staining can be selected for patients with high risk factors of CE.In clinical work,for patients with CE,the detection of ER expression may contribute to the choice of personalized hormone therapy.