Extravillous trophoblast invasion and decidualization in cesarean scar pregnancies.
Extravillous trophoblast invasion and decidualization in cesarean scar pregnancies.
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DOI：
10.1111/aogs.14435
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发表时间：
2022-10
影响因子：
4.3
通讯作者：
Li, Ping
中科院分区：
文献类型：
--
作者：
Gao, Lufen;Chen, Hui;Liu, Jing;Wang, Minghua;Lin, Fangfang;Yang, Guang;Lash, Gendie E.;Li, Ping
关键词：
不断增加的剖腹产率导致再次怀孕的数量增加，导致剖腹产疤痕妊娠。胚泡似乎优先附着在疤痕部位，这可能与该区域的蜕膜缺陷有关，导致异常植入，这反过来又会对妊娠的成功产生负面影响。本研究的目的是评估剖宫产瘢痕妊娠植入部位的瘢痕和邻近非疤痕区域的绒毛外滋养细胞、蜕膜和子宫肌层。标本取自经阴道或经腹超声诊断为妊娠6~11 周的剖宫产瘢痕妊娠患者(n=8例II型剖宫产瘢痕妊娠)。将剖宫产瘢痕妊娠组织分为疤痕和非疤痕区域，并将疤痕区域细分为非种植部位和种植部位。苏木精-伊红染色、Masson‘s三色染色和免疫组织化学染色后行连续切片，观察子宫肌层、绒毛外滋养细胞和蜕膜的变化。在剖宫产瘢痕妊娠中，与不在种植部位的瘢痕相比，种植部位的瘢痕表现出更多的纤维化，并破坏了子宫肌层，这与E-钙粘附素在绒毛外滋养细胞侵袭的反应中的不同模式有关。无瘢痕种植部位可见局部蜕膜，多核滋养层巨细胞堆积，浅层侵袭。这些特征在疤痕植入部位并不明显。这项研究强调，蜕膜驱动多核滋养层巨细胞分化，限制了侵袭程度。更好地描述这一分化过程可能有助于更好地管理和避免剖腹产疤痕妊娠的后果。本研究强调蜕膜驱动MTGC分化，限制其侵袭程度。更好地描述这一分化过程可能有助于更好地管理和避免CSP的后果。
The increasing cesarean section rate has led to an increase in the number of subsequent pregnancies resulting in a cesarean scar pregnancy. There appears to be preferential attachment of the blastocyst to the scar site, which may be associated with defective decidua in that region, resulting in abnormal implantation, which can in turn negatively affect the success of the pregnancy. The aim of the current study was to evaluate the extravillous trophoblast, decidua, and myometrium in scar and adjacent non‐scar regions of the implantation site of a cesarean scar pregnancy. Samples containing a gestational mass were obtained by laparoscopic excision from patients with a cesarean scar pregnancy at 6–11 weeks of gestation as diagnosed by transvaginal or transabdominal ultrasound (n = 8 type II cesarean scar pregnancy). Cesarean scar pregnancy tissues were separated into scar and non‐scar regions, and the scar regions were sub‐separated into non‐implantation and implantation sites. Serial sections were histologically examined after hematoxylin and eosin, Masson's trichrome and immunochemical staining, and changes in the myometrium, extravillous trophoblast, and decidua were evaluated. In cesarean scar pregnancy, compared with scars not in the implantation site, scars in the implantation site displayed increased fibrosis, and had disrupted myometrium, which was related to varying patterns of E‐cadherin expression as a response to extravillous trophoblast invasion. In addition, local decidua was found at the non‐scar implantation sites, with multinucleated trophoblast giant cell accumulation and shallow invasion. These features were not evident in the scar implantation sites. This study emphasizes that the decidua drives multinucleated trophoblast giant cell differentiation, limiting the degree of invasion. Better characterization of this differentiation process may be helpful for better management and avoidance of the consequences of cesarean scar pregnancy. This study emphasizes that the decidua drives MTGC differentiation, limiting the degree of invasion. Better characterization of this differentiation process may be helpful for better management and avoidance of the consequences of CSP.
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影响因子：
23.4
作者：
Kuijpers, Kamiel A. J.;Heesakkers, John P. F. A.;Schalken, Jack A.
通讯作者：
Schalken, Jack A.
DOI：
10.1111/j.1471-0528.1983.tb06743.x
发表时间：
1983-01-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
GERRETSEN, G;HUISJES, HJ;ELEMA, JD
通讯作者：
ELEMA, JD
影响因子：
3.1
作者：
Qian ZD;Weng Y;Du YJ;Wang CF;Huang LL
通讯作者：
Huang LL
DOI：
10.1186/1477-7827-2-58
发表时间：
2004-07-20
期刊：
Reproductive biology and endocrinology : RB&E
影响因子：
--
作者：
Hempstock, Joanne;Cindrova-Davies, Tereza;Burton, Graham J
通讯作者：
Burton, Graham J
影响因子：
3.8
作者：
Tantbirojn, P.;Crum, C. P.;Parast, M. M.
通讯作者：
Parast, M. M.