Department of Obstetrics and Gynecology, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, PR China.
Acta Obstet Gynecol Scand. 2011 Sep;90(9):966-71. doi: 10.1111/j.1600-0412.2011.01206.x. Epub 2011 Jul 18.
To investigate expression of matrix metalloproteinases (MMPs) and the tissue inhibitors of MMPs (TIMPs) at the feto-maternal interface and non-implantation sites in unruptured tubal pregnancies.
Prospective study. Setting. University teaching hospital.
Eighteen patients with unruptured tubal pregnancy undergoing salpingectomy.
Immunohistochemistry was used to detect MMP-2, -9 and -14, and TIMP-1, -2 and -3 at the feto-maternal interface and non-implantation regions of the Fallopian tube. Serum levels of human chorionic gonadotropin (β-hCG) were determined, and trophoblastic invasion was histologiclly classified as stage I when limited to the tubal mucosa and stage II when extending to the muscular layer.
The relation between serum β-hCG concentration with the depth of trophoblastic invasion into the tubal wall and differential expression of MMPs and TIMPs.
A significant difference in the β-hCG concentrations was seen between stage I and II invasion. Immunoreactivity for MMP-2, -9 and -14, and TIMP-1, -2 and -3 was primarily localized to cytotrophoblasts. At the implantation sites, the intensity of MMPs increased along the invasive pathway towards the maternal interstitium. The expression of MMP-2, MMP-14 and TIMP-3 was localized to the epithelium and smooth muscle cells of the Fallopian tube, while expression of MMP-9, TIMP-1 and TIMP-2 was weak or absent.
Human chorionic gonadotropin correlated positively with invasion stage of trophoblasts. At ectopic implantation sites, the expression of MMPs gradually increased with increasing invasion depth of trophoblasts. TIMP-1 and TIMP-2 were only weakly expressed. The imbalance between expression of MMPs and TIMPs at the ectopic implantation sites may lead to the extensive destructive degradation of the extracellular matrix.
探讨基质金属蛋白酶（MMPs）及其组织抑制剂（TIMPs）在未破裂输卵管妊娠的胎儿-母体界面和非着床部位的表达。
前瞻性研究。地点。大学教学医院。
18 例未破裂输卵管妊娠患者行输卵管切除术。
采用免疫组织化学法检测胎儿-母体界面和输卵管非着床部位 MMP-2、-9 和 -14 以及 TIMP-1、-2 和 -3 的表达。测定血清人绒毛膜促性腺激素（β-hCG）水平，并将滋养细胞侵袭分为局限于输卵管黏膜的Ⅰ期和延伸至肌层的Ⅱ期。
血清β-hCG 浓度与滋养细胞侵袭输卵管壁深度的关系及 MMPs 和 TIMPs 的差异表达。
Ⅰ期和Ⅱ期侵袭的β-hCG 浓度有显著差异。MMP-2、-9 和 -14 以及 TIMP-1、-2 和 -3 的免疫反应主要定位于细胞滋养层。在着床部位，MMPs 的表达强度沿着向母体间质的侵袭途径增加。MMP-2、MMP-14 和 TIMP-3 的表达定位于输卵管上皮细胞和平滑肌细胞，而 MMP-9、TIMP-1 和 TIMP-2 的表达较弱或缺失。
人绒毛膜促性腺激素与滋养细胞侵袭阶段呈正相关。在异位着床部位，MMPs 的表达随着滋养细胞侵袭深度的增加而逐渐增加。TIMP-1 和 TIMP-2 的表达较弱。异位着床部位 MMPs 和 TIMPs 表达失衡可能导致细胞外基质的广泛破坏降解。
