■本研究旨在检测IGF-1,bFGF,和PLGF及其在前置胎盘合并PAS疾病患者胎盘床组织中的表达。
■本病例及对照研究纳入40例妊娠34周至38周的完全性前置胎盘孕妇,分为两组:25例PAS患者(病例组)和15例无PAS患者(对照组)。剖宫产前2h采集静脉血,术中在胎盘植入部位采集胎盘床组织,然后进行组织学检查以评估胎盘肌层浸润的重力。根据FIGOPAS增加等级,这25例患者也分为三组:PAS等级I组,PAS二级组,和PASIII级组。IGF-1、bFGF、采用ELISA法检测血清中PLGF,使用qRT-PCR计算胎盘床组织中每种生物标志物的相对mRNA表达的平均比率。通过使用ImageJ软件进行IHC分析,定量测量染色强度和阳性细胞并表示为平均值。
■与没有PAS的患者相比,在前置胎盘PAS患者中IGF-1的血清水平较低,胎盘床表达较高(均p<0.0001)。与没有PAS的患者相比,在患有PAS疾病的前置胎盘患者中,PLGF具有较高的血清水平(p=0.0200)和较高的胎盘床表达(p<0.0001)。IGF-1血清水平下降至PASII级(PASI级的平均值分别为24.3±4.03、21.98±3.29和22.03±7.31,PAS等级II,PAS三级组,p=0.0006)。PLGF血清水平升高至PASII级(三组的平均值分别为12.96±2.74、14.97±2.56和14.89±2.14,p=0.0392)。然而,IGF-1和PLGFmRNA胎盘床表达增加至PASIII级。三组的mRNA平均值的相对表达对于IGF-1分别为3.194±1.40、3.509±0.63和3.872±0.70;对于PLGF分别为2.784±1.14、2.810±0.71和2.869±0.48(所有p<0.0001)。他们的IHC(免疫组织化学)染色也有增加的趋势,但p>0.05。在大多数分析切片中,bFGF在前置胎盘伴PAS疾病中没有显着表达(p>0.05)。
■IGF-1在胎盘床组织中的低血清水平和高表达,或PLGF在胎盘床组织中的高血清水平和高表达,可以区分患有FIGOPASI级和PASII级的前置胎盘患者和没有PAS疾病的患者。然而,他们无法显着预测FIGOPASII级和III级的胎盘侵袭程度。
UNASSIGNED: This study aims to detect the serum levels of IGF-1, bFGF, and
PLGF and their expressions in placental bed tissues of patients with placenta previa complicated with PAS disorders.
UNASSIGNED: This case and control study included 40 multiparous pregnant women with complete placenta previa between 34 weeks and 38 weeks of gestation and they were divided into two groups: 25 patients with PAS (case group) and 15 patients without PAS (control group). The venous blood samples were collected 2 h before the cesarean section, and the placental bed tissues were taken intraoperatively at the placental implantation site and then were histologically examined to evaluate the gravity of the myometrial invasion of the placenta. According to FIGO PAS increasing grading, the 25 patients were also divided into three groups: PAS grade I group, PAS grade II group, and PAS grade III group. The concentrations of IGF-1, bFGF, and
PLGF in serum were measured using ELISA, and the mean ratio of the relative mRNA expression of each biomarker in placental bed tissues was calculated using qRT-PCR. The staining intensity and the positive cells were quantitatively measured and expressed as means by using Image J software for IHC analysis.
UNASSIGNED: IGF-1 had low serum levels and high placental bed expression in placenta previa patients with PAS disorders compared to those without PAS (all p < 0.0001).
PLGF had high serum levels (p = 0.0200) and high placental bed expression (p < 0.0001) in placenta previa patients with PAS disorders compared to those without PAS. IGF-1 serum levels decreased up to PAS grade II (means were 24.3 ± 4.03, 21.98 ± 3.29, and 22.03 ± 7.31, respectively for PAS grade I, PAS grade II, PAS grade III groups, p = 0.0006).
PLGF serum levels increased up to PAS grade II (means were 12.96 ± 2.74, 14.97 ± 2.56, and 14.89 ± 2.14, respectively for the three groups, p = 0.0392). However, IGF-1 and
PLGF mRNA placental bed expression increased up to PAS grade III. The relative expression of mRNA means for the three groups was 3.194 ± 1.40, 3.509 ± 0.63, and 3.872 ± 0.70, respectively for IGF-1; and 2.784 ± 1.14, 2.810 ± 0.71, and 2.869 ± 0.48, respectively for PLGF (all p < 0.0001). Their IHC (immunohistochemical) staining also had increasing trends, but p > 0.05. bFGF was not significantly expressed in placenta previa with PAS disorders in most of the analysis sections (p > 0.05).
UNASSIGNED: Low serum levels and high expression in placental bed tissues of IGF-1, or high serum levels and high expression in placental bed tissues of PLGF, may differentiate placenta previa patients with FIGO PAS grade I and PAS grade II from those without PAS disorders. However, they could not significantly predict the degree of placental invasiveness in FIGO PAS grades II and III.