Karam Jose A, Vazquez Dolores V, Lin Victor K, Zimmern Philippe E
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110, USA.
BJU Int. 2007 Aug;100(2):346-50. doi: 10.1111/j.1464-410X.2007.06998.x. Epub 2007 May 26.
To compare elastin expression and elastic fibre width in the anterior vaginal wall of postmenopausal women with and with no bladder prolapse.
Full-thickness specimens were obtained from the upper lateral anterior vaginal wall of women having a large cystocele repaired (stage III or IV; prolapse group, 33) and the same location in patients with no prolapse having radical cystectomy (control group, 10). The percentage of elastin-positive tissue and elastic fibre width were measured by immunohistochemistry on 6 microm thick tissue sections from 10 random field readings per sample using image analysis software. The examiner was unaware of sample identity and the patients' clinical history.
The age was comparable between the control and prolapse groups (median 70.5 years), and the parity, vaginal deliveries, hormone replacement use, cigarette smokers and body mass index were no different between the groups. Immunohistochemical staining and morphometric analysis indicated that elastin expression in the prolapse group was 10.6%, vs 14.4% in the control group (P = 0.049). The median width of elastic fibres was 0.9 microm in the prolapse and 1.8 microm in the control groups (P < 0.001). Elastin expression and elastic fibre width appeared to be stable with increasing age in the prolapse group.
In this case-control study investigating elastin changes in postmenopausal women with prolapse, the elastin expression and fibre width were significantly lower in the vaginal wall of patients with a large cystocele than in controls of a similar age.
比较有膀胱膨出和无膀胱膨出的绝经后女性阴道前壁的弹性蛋白表达及弹性纤维宽度。
从接受巨大膀胱膨出修补术的女性（III期或IV期；脱垂组，33例）阴道前壁上外侧获取全层标本，以及从接受根治性膀胱切除术的无脱垂患者相同部位获取标本（对照组，10例）。使用图像分析软件，通过免疫组织化学法在每个样本10个随机视野读数的6微米厚组织切片上测量弹性蛋白阳性组织的百分比和弹性纤维宽度。检查者不知道样本身份和患者的临床病史。
对照组和脱垂组年龄相当（中位数70.5岁），两组间产次、阴道分娩次数、激素替代疗法使用情况、吸烟情况和体重指数无差异。免疫组织化学染色和形态计量分析表明，脱垂组弹性蛋白表达为10.6%，而对照组为14.4%（P = 0.049）。脱垂组弹性纤维的中位数宽度为0.9微米，对照组为1.8微米（P < 0.001）。在脱垂组中，弹性蛋白表达和弹性纤维宽度似乎随年龄增长而稳定。
在这项研究绝经后脱垂女性弹性蛋白变化的病例对照研究中，巨大膀胱膨出患者阴道壁的弹性蛋白表达和纤维宽度显著低于年龄相仿的对照组。
