目的研究盆底功能障碍性疾病(PFD)患者阴道前壁结缔组织的病理特征,探讨转化生长因子β1(TGF-β1)和弹性蛋白(Elastin)在PFD患者阴道前壁结缔组织中的表达及其对弹性纤维的影响。方法选择资料完整的59例PFD患者[其中压力性尿失禁(SUI)合并盆腔脏器脱垂(POP)30例,单纯POP 29例]阴道前壁结缔组织标本为研究组;同期45例非SUI、非POP患者标本为对照组。常规石蜡切片、苏木精-伊红(HE)染色、Masson染色、弹性纤维染色,免疫组化法和Western blot法检测两组TGF-β1和Elastin的蛋白表达。结果弹性纤维染色显示研究组的弹性纤维较对照组明显稀疏变细。Western blot检测与免疫组化染色结果类似,两组阴道前壁结缔组织均见TGF-β1和Elastin的表达,但研究组较对照组明显减弱,差异有统计学意义(均P〈0.01);相关性分析表明,TGF-β1和Elastin表达呈正相关。结论盆底结缔组织弹性纤维的破坏和缺失可能与PFD的发生密切相关,Elastin和TGF-β1的减少可能共同参与了PFD的发生、发展。TGF-β1可能是盆底弹性纤维Elastin表达的重要调控因子。
Objective To study the pathological features of connective tissues in the anterior vaginal wall of patients with pelvic floor disorders(PFD),and the expressions of transforming growth factorβ1(TGF-β1)and elastin in the connective tissues and their effect on elastic fibers.Methods A total of 59PFD patients were enrolled in the study,including 30patients with stress urinary incontinence(SUI)complicated with pelvic organ prolapse(POP)and 29with mere POP.Forty-five nonSUI and non-POP patients served as control group.All specimens were obtained on the hysteroscopy and they were subjected to HE staining,Masson staining,elastic fiber staining,immunohistochemistry and Western blot to detect the protein expression of TGF-β1and elastin,and the pathological changes of elastic fibers.Results Elastic fiber staining showed that the elastic fibers were sparsely distributed and became thinner in the PFD groups relative to the control group.The Western blot result was similar to that of the immunohistochemical staining,which showed that the expression levels of TGF-β1and elastin were significantly decreased in the PFD group compared with those in the control group(P〈0.01).Correlation analysis showed that TGF-β1and elastin were positively correlated.Conclusion Destruction and loss of elastic fibers in pelvic connective tissues may be closely related to the occurrence of PFD.Decreased elastin and TGF-β1expressions may be involved in the occurrence and development of PFD.TGF-β1may be the important regulatory factor of elastin expression in pelvic floor elastic fibers.