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目的:探讨Toll样受体TLR2、TLR4在妊娠期人阴道上皮组织中的表达和临床意义,以及与RVVC之间的关系。方法:采用免疫组织化学法检测妊娠期RVVC、妊娠期VVC、正常妊娠患者各30例阴道上皮细胞中TLR2和TLR4的表达情况,用Motic Med数码医学图像分析系统测定每个视野阳性染色部位平均OD值。结果:①正常妊娠、妊娠期VVC、妊娠期RV-VC患者阴道上皮细胞中均有TLR2的表达,且分别表达为(0.434±0.032)、(0.490±0.094)和(0.375±0.062),3组间的差异有统计学意义(F=21.722,P<0.01)。TLR2在妊娠期VVC组阴道上皮细胞中的阳性表达明显高于正常妊娠组(P<0.05);而妊娠期RVVC组阴道上皮细胞中的阳性表达则明显低于正常妊娠组(P<0.05)。②正常妊娠、妊娠期VVC、妊娠期RVVC患者阴道上皮细胞中均有TLR4的表达,3组间有统计学差异(F=105.645,P<0.01)。TLR4在妊娠期VVC组阴道上皮细胞中的阳性表达明显高于正常妊娠组(P<0.05);而妊娠期RVVC组阴道上皮细胞中的阳性表达则明显低于正常妊娠组(P<0.05)。③TLR2与TLR4在阴道上皮的表达量呈正相关(r=0.519,r=0.647,P<0.01)。结论:①正常妊娠、妊娠期VVC、妊娠期RVVC患者阴道上皮细胞中有TLR2、TLR4的表达,TLR2在阴道上皮强表达。②TLR2、TLR4可能参与了妊娠期VVC的发生发展,并影响其复发。③TLR2与TLR4在阴道上皮组织的表达量均呈正相关(r=0.519,r=0.647,P<0.01)。
Objective: To investigate the expression and clinical significance of Toll-like receptors TLR2 and TLR4 in human vaginal epithelial cells during pregnancy and their relationship with RVVC. Methods: Immunohistochemical method was used to detect the expression of TLR2 and TLR4 in 30 cases of vaginal epithelial cells in RVVC during pregnancy, VVC during pregnancy and 30 cases of normal pregnancy. The mean OD of positive staining area in each visual field was determined by Motic Med digital image analysis system value. Results: ①The expression of TLR2 in normal pregnancy, VVC in pregnancy and RV-VC in pregnancy were (0.434 ± 0.032), (0.490 ± 0.094) and (0.375 ± 0.062), respectively The difference was statistically significant (F = 21.722, P <0.01). The positive expression of TLR2 in vaginal epithelial cells of VVC group was significantly higher than that of normal pregnancy group (P <0.05). The positive expression of TLR2 in vaginal epithelial cells of RVVC group was significantly lower than that of normal pregnancy group (P <0.05). ② The expression of TLR4 in normal pregnancy, VVC in pregnancy and RVVC in pregnancy both had statistical significance (F = 105.645, P <0.01). The positive expression of TLR4 in vaginal epithelial cells of VVC group was significantly higher than that of normal pregnancy group (P <0.05). The positive expression of TLR4 in vaginal epithelial cells of RVVC group was significantly lower than that of normal pregnancy group (P <0.05). ③ The expression of TLR2 and TLR4 in the vaginal epithelium was positively correlated (r = 0.519, r = 0.647, P <0.01). Conclusion: ① The expression of TLR2 and TLR4 in the vaginal epithelial cells of normal pregnancy, VVC in pregnancy and RVVC in pregnancy, TLR2 strongly expressed in the vaginal epithelium. TLR2, TLR4 may be involved in the occurrence and development of VVC during pregnancy, and affect its recurrence. ③ The expression of TLR2 and TLR4 in the vaginal epithelial tissues were positively correlated (r = 0.519, r = 0.647, P <0.01).