Bodner-Adler Barbara, Bodner Klaus, Kimberger Oliver, Halpern Ksenia, Schneidinger Cora, Haslinger Peter, Schneeberger Christian, Horvat Reinhard, Umek Wolfgang
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Anesthesiology, Medical University of Vienna, Vienna, Austria.
Int Urogynecol J. 2020 Jan;31(1):101-106. doi: 10.1007/s00192-018-3820-2. Epub 2018 Dec 10.
Abnormalities of connective tissue structure or its repair mechanism may predispose women to pelvic organ prolapse (POP). We hypothesized that the expression of tenascin-X in the uterosacral ligament of postmenopausal women with symptomatic POP is increased compared with postmenopausal women without POP. Furthermore, we identified clinical risk factors associated with POP in our study population.
We conducted a retrospective case-control study in which 33 postmenopausal women with symptomatic POP ≥ pelvic organ prolapse quantification system (POP-Q) stage II were matched with 33 postmenopausal women without POP. Studied tissue specimens were taken from hysterectomy specimens, and tenascin-X expression was investigated by immunohistochemistry. The immunohistochemical profile of the uterosacral connective tissue of cases and controls was compared.
Tenascin-X was expressed in 94% of POP cases and in 91% of controls. Our study failed to show any statistically significant differences in tenascin-X expression between women with and without POP (p = 0.64). However, tenascin-X was significantly more expressed in cases with severe prolapse (POP-Q stage IV) compared with moderate prolapse stages (POP-Q stage II and III) (p = 0.001). Advanced patient age as well as early menopausal age remained independent risk factors associated with POP in multiple logistic regression analysis (p = 0.001).
No difference could be demonstrated between tenascin-X expression in patients with or without POP. Tenascin-X does not seem to play a major role in the pathogenesis of POP in postmenopausal women.
结缔组织结构或其修复机制异常可能使女性易患盆腔器官脱垂（POP）。我们假设，有症状的绝经后POP女性骶子宫韧带中腱生蛋白-X的表达高于无POP的绝经后女性。此外，我们在研究人群中确定了与POP相关的临床风险因素。
我们进行了一项回顾性病例对照研究，将33例有症状的POP≥盆腔器官脱垂量化系统（POP-Q）II期的绝经后女性与33例无POP的绝经后女性进行匹配。研究的组织标本取自子宫切除标本，通过免疫组织化学研究腱生蛋白-X的表达。比较病例组和对照组骶子宫结缔组织的免疫组织化学特征。
94%的POP病例和91%的对照组中表达了腱生蛋白-X。我们的研究未能显示有POP和无POP女性之间腱生蛋白-X表达有任何统计学上的显著差异（p = 0.64）。然而，与中度脱垂阶段（POP-Q II期和III期）相比，严重脱垂（POP-Q IV期）病例中腱生蛋白-X的表达明显更高（p = 0.001）。在多因素逻辑回归分析中，患者年龄较大以及绝经年龄较早仍然是与POP相关的独立危险因素（p = 0.001）。
有POP和无POP患者之间腱生蛋白-X表达无差异。腱生蛋白-X似乎在绝经后女性POP的发病机制中不起主要作用。
