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目的探讨不明原因反复种植失败(RIF)和正常生育妇女(FC)“种植窗”期血清雌二醇(E2)、孕酮(P)、E2/P水平和子宫内膜组织学时相、雌激素受体(ER)、孕激素受体(PR)和肿瘤坏死因子受体作用因子3(TRAF3)蛋白质的表达及其变化差异与反复种植失败的关系。方法 2009年10月至2012年3月于中山大学附属第一医院募集34名女性自愿者(反复种植失败患者15例,生育对照组19名)。在黄体生成激素(LH)+6~LH+9 d检测血清E2、P水平,微创法取子宫内膜组织;应用Western blot进行TRAF3的蛋白质水平半定量分析,免疫组织化学技术分析ER、PR和TRAF3定位表达与图象半定量分析。结果 “种植窗”期血清E2、P水平,子宫内膜腺上皮细胞ER、PR,基质细胞ER、PR在两组间差异无统计学意义,但RIF患者血清E2/P显著高于对照组(P=0.026)。免疫组织化学法分析显示TRAF3主要定位于子宫内膜腔上皮和腺上皮细胞,基质细胞表达很弱;免疫组化染色光密度值分析和Western blot半定量结果均显示不明原因RIF组TRAF3表达显著降低(P=0.02)。结论 “种植窗”期子宫内膜组织存在TRAF3的定位与半定量表达;E2/P升高可能影响子宫内膜组织局部分子的表达。
Objective To investigate the changes of serum estradiol (E2), progesterone (P), E2 / P and endometrial histology in patients with repeated unexplained implants (RIF) and normal birth women (FC) The Relationship Between the Expression of Estrogen Receptor (ER), Progesterone Receptor (PR) and Tumor Necrosis Factor Receptor Activation Factor 3 (TRAF3) Protein and Their Differences in Reproductive Failure. Methods From October 2009 to March 2012, 34 female volunteers (15 repeat failure patients and 19 fertility control subjects) were recruited from First Affiliated Hospital of Sun Yat-sen University. Serum levels of E2 and P were measured in serum of luteinizing hormone (LH) + 6 ~ LH + 9 d, and endometrial tissue was removed by minimally invasive method. Semiquantitative analysis of protein levels of TRAF3 was carried out by Western blot. Immunohistochemical analysis of ER, PR And TRAF3 localization expression and semi-quantitative analysis of the image. Results There was no significant difference between the two groups in the levels of E2 and P in seeding window, ER, PR in endometrial glandular epithelial cells, and ER and PR in stromal cells, but the serum E2 / P in RIF patients was significantly higher than that in control Group (P = 0.026). Immunohistochemical analysis showed that TRAF3 mainly located in endometrial luminal epithelial cells and glandular epithelial cells, stromal cells were weakly expressed; immunohistochemical staining and Western blot semi-quantitative analysis showed that the expression of TRAF3 was significantly decreased in RIF group (P = 0.02). Conclusion The localization and semi-quantitative expression of TRAF3 in the “implantation window” period endometrial tissue exists; E2 / P elevation may affect the expression of local molecules in the endometrium.