Lara Lúcia Alves da Silva, Ribeiro da Silva Alfredo, Rosa-e-Silva Julio Cesar, Silva-de-Sá Marcos Felipe, Rosa-e-Silva Ana Carolina Japur de Sá
Sexual Medicine Service of Human Reproduction Sector, Department of Gynaecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil.
Department of Pathology of the Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil.
Tissue Cell. 2014 Apr;46(2):159-64. doi: 10.1016/j.tice.2014.02.002. Epub 2014 Feb 26.
After menopause, critically estrogen low levels result in modifications in vaginal wall. This cross-sectional study aims to determine whether there is a change in the number of vessels in the lamina propria of the vagina after menopause in parallel to the ER-alpha expression on the vaginal wall. Twelve women who underwent a genital surgery for genital prolapse up to grade II were selected. They were divided into two groups: a premenopausal group (PG) consisting of six women who were 18-40 years old with FSH levels =12 mIU/ml and regular cycles, and a menopausal group (MG) consisting of six women at least one year after menopause who were <65 years old with FSH levels =40 mIU/ml. Slides were stained for ER-alpha immunohistochemistry, and an endothelial cell marker CD3 was used to label vessels which were identified by using a system for morphometry. The number of vessels was significantly higher in the PG than in the MG both on the anterior wall (PG: 1.055 ± 145.8 vessels/mm(2), MG: 346.6 ± 209.9 vessels/mm(2), p<0.0001) and on the posterior wall (PG: 1064 ± 303.3 vessels/mm(2), MG: 348.6 ± 167.3 vessels/mm(2), p=0.0005). The ER-alpha score was significantly higher in the PG than the score for the MG on both the anterior and posterior walls (PG: 6.0 ± 0.52, MG: 2.5 ± 0.89, p=0.007; PG: 5.8 ± 0.79, MG: 2.7 ± 0.95, p=0.03, respectively). There was a positive correlation between the ER-alpha score and the vessel concentration on the anterior (r=0.6656, p=0.018) and posterior (r=0.6738, p=0.016) vaginal walls. Age was strongly negatively correlated with vessel concentration on the vaginal walls (respectively r=-0.9033, p<0.0001, r=-0.7440, p=0.0055). Therefore, postmenopausal women with genital prolapse have a smaller number of vessels on the vaginal wall compared to normoestrogenic controls with the same pathological condition. Hypoestrogenism and advancing age are factors that are associated to these changes.
绝经后，雌激素水平极低会导致阴道壁发生改变。本横断面研究旨在确定绝经后阴道固有层血管数量的变化是否与阴道壁上的雌激素受体α（ER-α）表达平行。选取了12名接受了二级及以下生殖器脱垂手术的女性。她们被分为两组：绝经前组（PG），由6名年龄在18 - 40岁、促卵泡生成素（FSH）水平≤12 mIU/ml且月经周期规律的女性组成；绝经后组（MG），由6名绝经至少一年、年龄＜65岁且FSH水平≥40 mIU/ml的女性组成。制作玻片进行ER-α免疫组织化学染色，并使用内皮细胞标志物CD3标记血管，通过形态计量系统识别血管。前壁上，PG组的血管数量显著高于MG组（PG组：1.055±145.8条血管/mm²，MG组：346.6±209.9条血管/mm²，p＜0.0001）；后壁上也是如此（PG组：1064±303.3条血管/mm²，MG组：348.6±167.3条血管/mm²，p = 0.0005）。前壁和后壁上，PG组的ER-α评分均显著高于MG组（前壁：PG组6.0±0.52，MG组2.5±0.89，p = 0.007；后壁：PG组5.8±0.79，MG组2.7±0.95，p = 0.03）。前壁（r = 0.6656，p = 0.018）和后壁（r = 0.6738，p = 0.016）的阴道壁上，ER-α评分与血管密度呈正相关。年龄与阴道壁血管密度呈显著负相关（分别为r = -0.9033，p＜0.0001；r = -0.7440，p = 0.0055）。因此，与患有相同病理状况的正常雌激素水平对照组相比，患有生殖器脱垂的绝经后女性阴道壁上的血管数量较少。雌激素缺乏和年龄增长是与这些变化相关的因素。
