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目的通过对RSA患者和正常早孕女性绒毛、蜕膜中Survivin、VEGF及Stat3的测定,探讨不明原因反复流产患者的病因和母-胎界面滋养细胞增殖的调控机制。方法采用免疫组化法检测40例反复自然流产(RSA)患者及20例对照组的绒毛和蜕膜组织中Survivin、VEGF及Stat3含量。结果 RSA患者绒毛组织中Survivin、VEGF的表达水平高于正常妊娠组,差异有统计学意义(P<0.05),二者在绒毛中的表达呈正相关(r=0.268,P<0.05);RSA组与正常对照组的绒毛中Stat3的表达差异无统计学意义(P>0.05),Survivin与Stat3的表达不存在相关关系(r=-0.006,P>0.05);RSA组与正常对照组蜕膜中Survivin、VEGF和STAT3的表达差异无统计学意义(P>0.05)。结论本研究发现在胚胎发育和胎盘形成过程中VEGF通过上调Survivin,促进细胞增殖、血管形成和抗细胞凋亡的作用,参与胚胎着床、胎盘生长和浸润;而Stat3与其无关,RSA胚胎凋亡时Survivin的上调可能不通过JAK-STAT途径。
OBJECTIVE: To investigate the etiology and the regulation of trophoblast proliferation at maternal-fetal interface in patients with unexplained recurrent spontaneous abortion by measuring the expression of Survivin, VEGF and Stat3 in the chorion and decidua of RSA patients and normal early pregnant women. Methods The expressions of Survivin, VEGF and Stat3 in villi and decidua of 40 patients with recurrent spontaneous abortion (RSA) and 20 controls were detected by immunohistochemistry. Results The expression of Survivin and VEGF in chorionic villi of RSA patients was significantly higher than that of normal pregnancy group (P <0.05), and the expression of Survivin and VEGF in chorionic villi was positively correlated (r = 0.268, P <0.05) There was no significant difference between the expression of Stat3 and the expression of Stat3 (r = -0.006, P> 0.05) in RSV group and normal control group There was no significant difference in the expression of Survivin, VEGF and STAT3 (P> 0.05). Conclusions This study found that VEGF plays an important role in embryo implantation and placenta growth and invasion by up-regulating Survivin in embryonic development and placenta formation, promoting cell proliferation, angiogenesis and anti-apoptosis. Stat3 has nothing to do with it but apoptosis of RSA embryo Upregulation of Survivin may not pass through the JAK-STAT pathway.