雌、孕激素受体及端粒酶在种植窗期子宫内膜中表达的研究-现代医学

雌、孕激素受体及端粒酶在种植窗期子宫内膜中表达的研究

单位：1. 暨南大学附属深圳市宝安区妇幼保健院生殖健康科, 广东深圳 518100;
2. 暨南大学附属深圳市宝安区妇幼保健院病理科, 广东深圳 518100;
3. 暨南大学附属深圳市宝安区妇幼保健院妇科, 广东深圳 518100;
4. 暨南大学附属深圳市宝安区妇幼保健院中心实验室, 广

关键词：反复种植失败种植窗端粒酶催化亚基雌激素受体α 孕激素受体

分类号：R714.2

出版年·卷·期（页码）：2021·49·第七期（756-760）

摘要：

目的：了解在种植窗期中的子宫内膜中的雌激素受体α（ER-α）、孕激素受体（PR）及端粒酶催化亚基（TERT）的表达情况，探讨发生反复种植失败（RIF）的可能原因。方法：选择2014年11月至2019年5月在暨南大学附属深圳市宝安区妇幼保健院生殖健康科及妇科因试管婴儿RIF者45例（RIF组）及正常妊娠女性30例（正常妊娠组）作为研究对象，检测两组患者在种植窗期子宫内膜的厚度、血清雌二醇（E₂）、孕酮（P）的水平以及子宫内膜中TERT、ER-α、PR表达情况。结果：RIF组与正常妊娠组在种植窗期的血清E₂、P水平比较，差异无统计学意义（P>0.05），但RIF患者子宫内膜厚度偏薄，差异有统计学意义（P<0.05）； RIF组种植窗期子宫内膜中的TERT表达较正常妊娠组明显升高，ER-α表达低于正常妊娠组，PR表达高于正常妊娠组，差异均有统计学意义（P<0.05）； TERT表达与ER-α（r=-0.696 4，P<0.001）、PR （r=0.347 1，P=0.019 5）的表达均有显著相关性；在种植窗期血清中E₂/P值在两组比较中差异无统计学意义，但RIF组中子宫内膜中的ER-α/PR值在种植窗期表达下降，差异有统计学意义（P<0.001）。结论：子宫内膜偏薄，子宫内膜中ER-α、PR的表达失调以及TERT表达增强是引起种植失败的可能原因。

Objective: To investigate the expression of estrogen receptor α (ER-α), progesterone receptor (PR) and telomerase catalytic subunit(TERT) in endometrium during implantation window, and to explore the possible causes of repeated implantation failure (RIF). Methods: From November 2014 to May 2019, 45 RIF patients (RIF group) and 30 normal pregnant women (normal pregnancy group) in reproductive health and gynecology department of Shenzhen Baoan Womens and Childrens Hospital, Jinan University were selected as the research objects. The endometrial thickness, serum estradiol (E₂) and progesterone (P) levels, and the expression of TERT, ER-α and PR in endometrium of the two groups were detected.Results: There was no significant difference in serum E₂ and P levels between two groups during implantation window (P>0.05), but there was significant difference in endometrial thickness between RIF group and normal pregnancy group (P<0.05). TERT expressionin endometrium of RIF group during implantation window was significantly higher than that of normal pregnancy group, while ER-α expressionwas lower and PR expressionwas higher than those of normal pregnancy group (P<0.05). The expression of TERT was significantly correlated with the expression of ER-α (r=-0.696 4, P<0.001) and PR(r=0.347 1, P=0.019 5). There was no significant difference in the value of E₂/P between the two groups，but compared with normal pregnancy group, the expression of ER-α/PR in endometrium of RIF group decreased during the implantation window, and the difference was statistically significant (P<0.001). Conclusion: Thin endometrium, unbalanced expression of ER-α, PR and increased expression of TERT in endometrium are the possible causes of implant failure.

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