细胞凋亡和PCNA在早孕绒毛滋养细胞及蜕膜中的表达与自然流产的关系

目的 :研究细胞凋亡与细胞增殖在早孕绒毛滋养细胞和蜕膜中的表达及与自然流产的关系。方法 :对孕 3月内 2 0例正常妊娠、2 0例第 1次自然流产 (SA)和 15例反复自然流产 (RSA)的绒毛和蜕膜组织应用TdT介导的dUTP缺口原位末端标记技术(TUNEL)检测细胞凋亡 ,应用免疫组织化学SP法检测增殖细胞核抗原 (PCNA)。结果 :正常早孕绒毛细胞滋养细胞、合体滋养细胞和蜕膜中的凋亡指数分别为 7.2 1± 1.2 4、8.89±2 .5 2和 7.70± 0 .82 ;SA组为 15 .4 0± 6 .5 9、2 5 .83± 6 .83和 32 .0 3± 3.2 7;RSA组为 18.77±8.2 2、34.0 2± 13.4 9和 34.96± 5 .4 6。增殖指数在正常早孕绒毛细胞滋养细胞、合体滋养细胞和蜕膜中为 6 4 .13± 5 .90、0和 6 2 .0 8± 4 .76 ;SA组为 6 7.0 2± 6 .79、36 .13± 3.5 6和 6 4 .94± 4 .6 0 ;RSA组为 6 8.6 7± 8.4 5、33.6 7± 4 .0 8和 6 3.99± 5 .5 4。即孕 3月内正常妊娠的绒毛和蜕膜组织中均有一定量的细胞凋亡与细胞增殖存在。SA与正常早孕相比绒毛和蜕膜中的细胞凋亡均明显增加 (P <0 .0 1) ,RSA合体滋养细胞凋亡也较SA明显增加 (P <0 .0 5 ) ;细胞滋养细胞和蜕膜中的细胞增殖在自然流产与正常妊娠间无明显差异 (P >0 .0 5 )。结论 :细胞凋亡和增殖的平衡与妊娠维持?

The relationship between the expressions of apoptosis and PCNA in trophoblasts and decidua in early pregnancy and the spontaneous abortion

Objective:To investigate the relationship between the expression of apoptosis and proliferation in chorionic villi and decidua in early pregnancy and spontaneous abortion.Methods: Chorionic villi and decidua of first-trimester were obtained from 20 normal pregnancies,20 cases of the first time spontaneous abortion and 15 recurrent spontaneous abortion cases.Apoptosis was detected using DNA in situ terminal deoxynucleotidyl transferase-mediated dUTP biotin nick ending labeling (TUNEL),proliferating cell nuclear antigen (PCNA) of the marker for proliferation was detected using immunohistochemical staining (SP). Results: In normal pregnancies,the apoptosis indexes of cytotrophoblasts (CT),syncytotrophoblasts (ST) and decidua were 7.21±1.24,8.89±2.52 and 7.70±0.82;in SA they were 15.40±6.59,25.83±6.83,32.03±3.27 and in RSA they were 18.77±8.22,34.02±13.49 and 34.96±5.46.In normal pregnancies,the proliferation indexes of CT?ST and decidua were 64.13±5.90,0 and 62.08±4.76;in SA they were 67.02±6.79,36.13±3.56,64.94±4.60 and in RSA they were 68.67±8.45,33.67±4.08,63.99± 5.54.Apoptosis and proliferation occur in the human villi and decidua during the first trimester of normal pregnancy.The apoptosis was greatly intensified in cases of abortion (P<0.01) and significant difference of the ST also was observed between the RSA and SA,but the proliferation was not intensified in CT and decidua (P>0.05). Conclusions: Apoptosis proliferation balance should play a role in the maintenance of pregnancy.The break of the balance may be a cause of spontaneous abortion and apoptosis probably play a more important role in the mechanism.