妊娠期及妊高征滋养细胞E-钙粘附素的表达

目的 :研究妊娠各期胎盘床绒毛外细胞滋养细胞 (EVT)E 钙粘附素 (E cad herin)表达的变化 ,并与妊高征胎盘床中的表达进行比较。方法 :用免疫组化法 ,对 4 0例标本进行染色 (孕早期 9份 ,孕中期 4份 ,孕晚期 2 7份 ,其中妊高征组 8份 ,非妊高征组 19份 )。结果 :孕 10周前绒毛的细胞滋养细胞仅小部分E cadherin染色呈弱阳性。孕 10周后 ,绒毛的细胞滋养细胞染色均为强阳性 ,细胞柱区域从近端到远端染色逐渐减弱。孕中期EVT染色几乎为阴性 ,孕晚期又稍有增强。妊高征时EVT染色减弱不明显。妊高征组和非妊高征组染色阳性的细胞分别为 2 7.4 5 %和 12 .74 % (P <0 .0 1)。结论 :E cadherin表达减弱或消失有利于细胞滋养细胞的浸润。妊高征时 ,E cadherin表达减弱不明显 ,细胞滋养细胞浸润能力减弱 ,以至螺旋动脉缺乏妊娠期生理性变化 ,导致发生妊高征。

The expression of E-cadherin in cytotrophoblasts in normal pregnan cy and preeclampsia.

Objective:To study the expression of E cadherin of extravillous cytotrophoblastic cells(EVT)in placental bed and compare with its expression in preeclampsia.Methods:Immunohistochemical technique was used to stain 40 cases.Result:All the cytotrophoblasts of villi had strong positive E cadherin staining after 10 weeks of pregnancy.In cytotrophoblastic column,the staining became weaker gradually from the proximity to the distance.In the second trimester,extravillous trophoblasts almost stain negative.In the third trimester,the coloration of the EVT became stronger than that in the second trimester.In preeclampsia,the coloration of EVT was not as distinct as the non preeclampsia cases during the same trimester;and the positive rates in preeclampsia and non preeclampsia were 27.45% and 12.74% respectively.There was significant difference between the two groups(P<0.01).Conclusions:The loss and/or aberrance of the expression of E cadherin in EVT can enhance their invasive ability.In preeclampsia,the fading of the expression is not distinct,so the ability of invasion is impaired.Consequently,the physiological changes of the spiral arteries in preeclampsia are limited,and they likely result in the symptoms of preeclampsia.