HOXA-11基因与不孕及妊娠失败关系的研究

目的 :研究HOXA 11基因与不孕及妊娠失败的关系。方法 :选择 4 1例不明原因不孕症患者及 30例难免流产患者 ,同时选择 2 8例正常未孕者及 18例正常早期妊娠者分别作为对照组 ,留取子宫内膜或蜕膜组织。子宫内膜标本通过组织学检查分为增生期或分泌期。难免流产及正常妊娠组均妊娠 6～ 9周。采用原位杂交方法检测所有子宫内膜或蜕膜组织中的HOXA 11基因mRNA的表达。结果 :整个月经周期子宫内膜腺上皮细胞及间质细胞中均有HOXA 11基因mRNA表达 ,并因月经周期不同而有所波动。HOXA 11基因mRNA在分泌中晚期子宫内膜间质细胞中阳性表达率为 10 0 % ,在增生期子宫内膜间质细胞中的阳性表达率为 6 3.6 % ,差异有显著性 (P <0 .0 5 ) ;在不明原因不孕症患者中HOXA 11基因失去了它在正常子宫内膜表达的周期性变化 ,而且基因表达缺失明显。HOX A 11基因在正常增生期及分泌期子宫内膜腺上皮细胞或间质细胞中的阳性表达率分别为90 .9%、82 .4 %和 6 3.6 %、10 0 % ,在不孕症增生期及分泌期子宫内膜两种细胞的阳性表达率分别为 38.9%、4 7.8%和 2 2 .2 %、39.1% ,两组分别比较 ,差异均有显著性 (P <0 .0 5 ) ;HOXA 11基因在正常早期妊娠蜕膜细胞中持续表达 ,其阳性表达率均为 10 0 % ,在难免流产蜕膜细胞中的阳性表达

Relationship between HOXA-11 gene and infertility and missed gestation

Objective:To study the relationship of HOXA 11 gene and infertility and missed gestation.Methods:41 unexplained infertility cases and 30 cases with inevitable abortion were enrolled into present study.28 cases of normal women and 18 cases of normal pregnant women were selected as control.All endometrial or decidual specimens were collected.All endometria were divided into proliferative phase and mid to late secretory phase according to histologic examination.The gestational duration of inevitable abortions and controls were 6 to 9 weeks.The mRNA expression of HOXA 11 gene in endometria or deciduas were detected by in situ hybridization.Results:HOXA 11 gene mRNA expressed in the glandular and stromal cells of endometria of normal women during the menstral cycle.The positive rate of HOXA 11 gene mRNA expression in stromal cells of secretory phase was 100%,which was significantly higher than that of stromal cells in proliferative phase(63.6%,P<0.05).In infertile group,the expression of HOXA 11 gene was not changed following the menstral cycle.HOXA 11 gene positive rates in glandular or stromal cells in normal proliferative and secretory endometrium were 90.9%,82.4% and 63.6%,100% respectively,which was significantly higher than those of unexplained infertile group(38.9%,47.8% and 22.2%,39.1%,P<0.05).HOXA 11 gene mRNA expressed persistently in the decidua.The positive rate of HOXA 11 gene in normal decidua was 100%,which was significantly higher than that of inevitable abortion group(33.3%,P<0.05).Conclusion:There is a close relationship between HOXA 11 gene and implantation.Abnormal expression of HOXA 11 gene may be one of the reasons caused female infertile or missed gestation.