Huang Xiang-hua, Zhang Lin, Gao Zhi-min, Zhu Zhi-jie
Department of Obstetrics and Gynecology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
Zhonghua Fu Chan Ke Za Zhi. 2009 Aug;44(8):588-92.
In order to evaluate the changes of neovaginal defense function in the sight of physical barrier by investigating the changes in the histological morphology and expression of occludin, zona occluden-1 (ZO-1) in mucosal cells of the neovagina in patients undergoing vaginal construction by sigmoid colon.
Fifteen cases with neovagina constructed by sigmoid colon matched with 15 cases' vaginal mocusa as control specimens were observed with light microscopic and electron microscopic methods. At the same time, the expression of occludin and ZO-1 were semiquantitatively measured by streptavidin-perosidase (SP) immunohistochemical method.
(1) Squamous metaplasia was observed in colonic mucosa from lower one-third of the artificial vagina in 10 cases (67%, 10/15). (2) The intercellular tight junctions of neovaginal mucosa became shorter and wider, the number of them were decreased or disappeared by electron microscopic study. (3) In upper neovagina, the positive rates of occludin and ZO-1 expression in mucosal cells were 80% (12/15) and 73% (11/15), respectively. In lower neovaginal mucosa where squamous metaplasia occurred, the positive rates of two protein expression in cells were both 100% (10/10) and also was 100% (15/15) in control group, which showed significant difference (P < 0.05, P < 0.01). In lower neovaginal mucosa where squamous metaplasia hadn't occurred, the positive expression of two protein in cells (4/5, 2/5) were significantly lower than those in lower neovaginal mucosa where squamous metaplasia had happened 100% (10/10), 100% (10/10) and in control group [100% (15/15), 100% (15/15)] (P < 0.05), while there were no significantly difference in positive expression of two protein in cells between this group and upper neovagina (P > 0.05).
The squamous metaplasia had occurred in lower neovaginal mucosa. The decreased expression of occludin and ZO-1 in upper and lower neovaginal mucosa where squamous metaplasia didn't occurred. However, In lower neovaginal mucosa where squamous metaplasia occurred, the expression of occludin and ZO-1 in cells were similar to those in control group, which might play a role in the defense function of neovaginal mucosa.
通过观察乙状结肠阴道成形术患者新阴道黏膜细胞中紧密连接蛋白occludin、闭合蛋白1（ZO-1）的组织形态学变化及表达情况，从物理屏障角度评估新阴道防御功能的变化。
选取15例乙状结肠阴道成形术患者的新阴道组织，以15例正常阴道黏膜组织作为对照，采用光镜和电镜观察。同时，应用链霉亲和素-过氧化物酶（SP）免疫组化法半定量检测occludin和ZO-1的表达。
（1）10例（67%，10/15）患者人工阴道下1/3的结肠黏膜出现鳞状上皮化生。（2）电镜观察发现新阴道黏膜细胞间紧密连接变短、增宽，数量减少或消失。（3）新阴道上段黏膜细胞中occludin和ZO-1表达阳性率分别为80%（12/15）和73%（11/15）。新阴道下段发生鳞状上皮化生处黏膜细胞中两种蛋白表达阳性率均为100%（10/10），对照组阳性率也为100%（15/15），差异有统计学意义（P<0.05，P<0.01）。新阴道下段未发生鳞状上皮化生处黏膜细胞中两种蛋白阳性表达（4/5，2/5）明显低于新阴道下段发生鳞状上皮化生处[100%（10/10），100%（10/10）]及对照组[100%（15/15），100%（15/15）]（P<0.05），但与新阴道上段相比差异无统计学意义（P>0.05）。
新阴道下段黏膜发生鳞状上皮化生。新阴道上段及未发生鳞状上皮化生的下段黏膜中occludin和ZO-1表达降低。而新阴道下段发生鳞状上皮化生处黏膜细胞中occludin和ZO-1表达与对照组相似，可能对新阴道黏膜防御功能起作用。
