Li Yuye, Yu Shuyi, Liu Wenjuan, Chen Yawen, Yang Xiaobing, Wu Juanhua, Xu Mingjuan, You Guanying, Lian Ruochun, Huang Chunyu, Chen Wanru, Zeng Yong, Liu Fenghua, Diao Lianghui
Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, China.
Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen, China.
Front Endocrinol (Lausanne). 2025 Jan 22;15:1437781. doi: 10.3389/fendo.2024.1437781. eCollection 2024.
This study was conducted to determine the influence of the number of CD138 cells in the proliferative endometrium on pregnancy outcomes.
This retrospective cohort study was conducted from January to August 2018. A total of 664 infertile women who were not diagnosed with chronic endometritis (CE) and who had not received the respective antibiotic treatment were studied. Immunostaining was performed for the plasmacyte marker CD138. The number of CD138+ cells was compared in the proliferative and mid-luteal phases of the same patients without antibiotic therapy. Infertile patients were separated into three groups based on the number of positive lesions [the number of high power fields (HPFs) containing no less than five CD138 cells]: 0 (n = 474), 1-2 (n = 125), and 3 positive lesions (n = 104). The pregnancy outcomes of the infertile women undergoing fertilization-embryo transfer (IVF-ET) among the three groups were then compared.
There was a much higher level of CD138+ cells during proliferation than during the mid-luteal phase (P <0.0001). Pregnancy outcomes did not differ between the groups with 0 and 1-2 positive lesions. However, the ≥3 positive lesions group ( =0.006, =0.029) had significantly lower ongoing pregnancy and live birth rates compared with the no positive lesion group. Although the 0 and ≥3 positive lesions groups showed a trend toward higher rates of clinical pregnancy ( =0.132), these differences failed to reach statistical significance. After age, body mass index (BMI), and clinical features were adjusted for, the 3 positive lesions group showed significantly lower live birth rates (aOR, 1.84; 95%CI, 1.08-3.15; =0.026), clinical pregnancy (adjusted odds ratio (aOR), 1.78; 95% CI, 1.06-2.95; =0.028), and ongoing pregnancy (aOR, 1.85; 95% CI, 1.09-3.15; =0.024). The analysis demonstrated that the smallest number of stromal CD138 cells suggestive of CE patients requiring treatment was defined as 3 positive lesions during the proliferation.
Different diagnostic criteria for CE should be created for the proliferative and mid-luteal phases. The analysis demonstrated that the smallest number of stromal CD138 cells suggestive of CE patients was defined as 3 positive lesions during the proliferative phase.
本研究旨在确定增殖期子宫内膜中CD138细胞数量对妊娠结局的影响。
本回顾性队列研究于2018年1月至8月进行。共研究了664名未诊断为慢性子宫内膜炎（CE）且未接受相应抗生素治疗的不孕妇女。对浆细胞标志物CD138进行免疫染色。比较了同一未接受抗生素治疗患者增殖期和黄体中期的CD138+细胞数量。不孕患者根据阳性病变数量[包含不少于5个CD138细胞的高倍视野（HPF）数量]分为三组：0个（n = 474）、1 - 2个（n = 125）和3个阳性病变（n = 104）。然后比较三组中接受体外受精 - 胚胎移植（IVF - ET）的不孕妇女的妊娠结局。
增殖期CD138+细胞水平明显高于黄体中期（P <0.0001）。0个和1 - 2个阳性病变组的妊娠结局无差异。然而，≥3个阳性病变组（ =0.006， =0.029）与无阳性病变组相比，持续妊娠率和活产率显著降低。虽然0个和≥3个阳性病变组临床妊娠率有升高趋势（ =0.132），但这些差异未达到统计学意义。在对年龄、体重指数（BMI）和临床特征进行调整后，≥3个阳性病变组的活产率（调整后比值比（aOR），1.84；95%置信区间，1.08 - 3.15； =0.026）、临床妊娠率（调整后比值比（aOR），1.78；95%置信区间，1.06 - 2.95； =0.028）和持续妊娠率（aOR，1.85；95%置信区间，1.09 - 3.15； =0.024）显著降低。分析表明，增殖期提示CE患者需要治疗的最小间质CD138细胞数量定义为≥3个阳性病变。
应针对增殖期和黄体中期制定不同的CE诊断标准。分析表明，增殖期提示CE患者的最小间质CD138细胞数量定义为≥3个阳性病变。
