Ibrahim Mohamed G, Chiantera Vito, Frangini Sergio, Younes Shadi, Köhler Christhardt, Taube Eliane T, Plendl Johanna, Mechsner Sylvia
Clinic for Gynaecology, Charité University of Medicine, Berlin, Germany.
Clinic for Gynaecology, Asklepios Clinic of Hamburg, Hamburg, Germany.
Fertil Steril. 2015 Dec;104(6):1475-83.e1-3. doi: 10.1016/j.fertnstert.2015.09.002. Epub 2015 Oct 9.
To determine if ultrastructural tissue trauma occurs in the junctional zone in uteri in adenomyosis.
A case-control experimental study.
Endometriosis research center.
PATIENT(S): Twelve uteri with adenomyosis, and 9 uteri without adenomyosis, were gained during laparoscopy-assisted vaginal hysterectomy.
INTERVENTION(S): Transmission electron microscopic study of the junctional zone, as well as immunohistochemical staining for epithelial cadherin, and van Gieson staining and immunofluorescence for CD45 and CD68.
MAIN OUTCOME MEASURE(S): Analysis of the electron microscopy photos and the immunoreactive scores of the staining.
RESULT(S): The inner myometrial muscle fibers were diversely arranged in adenomyosis; they were parallel to the basal endometrial glands in nonadenomyosis. Nuclear membrane infolding of the basal glandular epithelium and the disruption of the interface between basal endometrium and inner myometrium in adenomyosis (but not in nonadenomyosis) were evident. Intraepithelial pale cells were seen in the basal endometrial glands in both groups, but they lacked CD45 and CD68 expression. They were seen actively migrating into the stroma in adenomyosis only.
CONCLUSION(S): The myofiber disarray in the inner myometrium, and the nuclear membrane irregularities in adenomyosis, are evidence for ultramicro-trauma in adenomyosis. The migrating nonleukocytic pale cells may be involved in pathogenesis of adenomyosis.
确定子宫腺肌病中子宫交界区是否发生超微结构组织损伤。
病例对照实验研究。
子宫内膜异位症研究中心。
在腹腔镜辅助下阴式子宫切除术中获取12例子宫腺肌病患者的子宫以及9例非子宫腺肌病患者的子宫。
对交界区进行透射电子显微镜研究，以及对上皮钙黏蛋白进行免疫组织化学染色，对CD45和CD68进行范吉森染色及免疫荧光染色。
电子显微镜照片分析及染色的免疫反应评分。
子宫腺肌病中子宫肌层内层肌纤维排列多样；在非子宫腺肌病中，它们与子宫内膜基底部腺体平行。子宫腺肌病（而非非子宫腺肌病）中基底腺上皮细胞核膜内陷以及基底子宫内膜与子宫肌层内层之间界面的破坏很明显。两组的子宫内膜基底部腺体中均可见上皮内淡染细胞，但它们缺乏CD45和CD68表达。仅在子宫腺肌病中可见它们活跃地迁移至间质。
子宫肌层内层肌纤维排列紊乱以及子宫腺肌病中的核膜不规则是子宫腺肌病中超微损伤的证据。迁移的非白细胞淡染细胞可能参与子宫腺肌病的发病机制。
