Significance of C4d Immunostaining in Placental Chronic Intervillositis
Significance of C4d Immunostaining in Placental Chronic Intervillositis
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DOI：
10.2350/14-12-1582-oa.1
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发表时间：
2015-09-01
影响因子：
1.9
通讯作者：
Oron, Assaf P.
中科院分区：
文献类型：
--
作者：
Bendon, Robert W.;Coventry, Susan;Oron, Assaf P.
补体分裂产物C4d的沉积作为抗体介导的移植排斥反应中补体活化的标记物被广泛研究。在包括自然流产、梗死和不明原因的绒毛炎在内的胎盘疾病过程中也观察到C4d。大量慢性绒毛间炎是一种罕见的胎盘异常，与生长受限、胎儿死亡和复发性胎儿丢失的风险增加有关。在这项研究中，我们评估了有绒毛间单核细胞积聚的胎盘的C4d免疫染色，有无绒毛炎。选取Kosair儿童医院（Louisville， KY）和西雅图儿童医院（Seattle， WA）存档的胎盘，分为4组，合并合并妊娠的绒毛间炎16例，合并合并绒毛间炎15例，合并合并绒毛炎20例，合并合并合并绒毛炎13例，绒毛间间隙均存在不同程度的单核细胞。代表性标本块进行C4d免疫组织化学染色。合胞滋养细胞微绒毛表面阳性染色百分率由5位病理学家评分，确定如下共识评分：0 = 0% ~ 5%；1 = 5% ~ 25%；2 = 25% ~ 75%；3 >= 75%在许多胎盘中，C4d免疫染色定位于合体滋养细胞的微绒毛边界。C4d染色与绒毛间炎的相关性比与绒毛炎的相关性更强（优势比：6.3；置信区间：2.1-18.7;P = 0.001）。
Deposition of the complement split product C4d is a phenomenon studied extensively as a marker for complement activation in antibody-mediated transplant rejection. C4d also is observed in placental disease processes including spontaneous abortion, infarct, and villitis of unknown origins. Massive chronic intervillositis is a rare placental abnormality associated with increased risk of growth restriction, fetal death, and recurrent fetal loss. In this study, we evaluated C4d immunostaining in placentas with accumulation of intervillous monocytes with and without villitis. Archived placentas from Kosair Children's Hospital (Louisville, KY) and Seattle Children's Hospital (Seattle, WA) were selected and divided into 4 groups, 16 cases of intervillositis with complicated pregnancy, 15 cases of uncomplicated intervillositis, 20 cases of complicated villitis, and 13 cases of uncomplicated villitis, all with varying degrees of monocytic cells in the intervillous space. Representative specimen blocks were immunohistochemically stained for C4d. The percentage of positive staining of the microvillous surface of the syncytiotrophoblast was scored by five pathologists, and the following consensus score was determined: 0 = 0% to 5%; 1 = 5% to 25%; 2 = 25% to 75%; and 3 >= 75%. C4d immunostain localized to the microvillous border of syncytiotrophoblast in many of the placentas. C4d staining was more strongly associated with intervillositis than with villitis (odds ratio: 6.3; confidence interval: 2.1-18.7; P = 0.001).