Ultramicro-trauma in the endometrial-myometrial junctional zone and pale cell migration in adenomyosis
Ultramicro-trauma in the endometrial-myometrial junctional zone and pale cell migration in adenomyosis
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DOI：
10.1016/j.fertnstert.2015.09.002
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发表时间：
2015-12-01
影响因子：
6.7
通讯作者：
Mechsner, Sylvia
中科院分区：
文献类型：
--
作者：
Ibrahim, Mohamed G.;Chiantera, Vito;Mechsner, Sylvia
目的：确定子宫腺肌症患者交界区是否发生超微结构组织损伤。设计：病例对照实验研究。地点：子宫内膜异位症研究中心。患者：腹腔镜辅助阴式子宫切除术中获得 12 例子宫腺肌症子宫和 9 例无子宫腺肌症子宫。干预措施：交界区透射电镜研究以及免疫组化检查上皮钙粘蛋白染色，van Gieson染色，CD45、CD68免疫荧光。主要指标：电镜照片及染色免疫反应评分分析。结果：子宫腺肌病内肌层肌纤维排列多样；它们与非子宫腺肌病的基底子宫内膜腺体平行。在子宫腺肌病中（但在非子宫腺肌病中则不然），基底腺上皮的核膜内陷以及基底子宫内膜和内肌层之间的界面破坏是明显的。两组子宫内膜腺体基底均可见上皮内苍白细胞，但缺乏CD45和CD68表达。仅在子宫腺肌病中观察到它们主动迁移至间质。结论：子宫内膜肌纤维紊乱和子宫腺肌病核膜不规则是子宫腺肌病超微创伤的证据。迁移的非白细胞苍白细胞可能参与子宫腺肌病的发病机制。 (C) 2015 年，美国生殖医学会。
Objective: To determine if ultrastructural tissue trauma occurs in the junctional zone in uteri in adenomyosis.Design: A case-control experimental study.Setting: Endometriosis research center.Patient(s): Twelve uteri with adenomyosis, and 9 uteri without adenomyosis, were gained during laparoscopy-assisted vaginal hysterectomy.Intervention(s): Transmission electron microscopic study of the junctional zone, as well as immunohistochemical staining for epithelial cadherin, and van Gieson staining and immunofluorescence for CD45 and CD68.Main Outcome Measure(s): Analysis of the electron microscopy photos and the immunoreactive scores of the staining.Result(s): The inner myometrial muscle fibers were diversely arranged in adenomyosis; they were parallel to the basal endometrial glands in nonadenomyosis. Nuclear membrane infolding of the basal glandular epithelium and the disruption of the interface between basal endometrium and inner myometrium in adenomyosis (but not in nonadenomyosis) were evident. Intraepithelial pale cells were seen in the basal endometrial glands in both groups, but they lacked CD45 and CD68 expression. They were seen actively migrating into the stroma in adenomyosis only.Conclusion(s): The myofiber disarray in the inner myometrium, and the nuclear membrane irregularities in adenomyosis, are evidence for ultramicro-trauma in adenomyosis. The migrating nonleukocytic pale cells may be involved in pathogenesis of adenomyosis. (C) 2015 by American Society for Reproductive Medicine.