Gerretsen G, Huisjes H J, Hardonk M J, Elema J D
Br J Obstet Gynaecol. 1983 Jan;90(1):34-9. doi: 10.1111/j.1471-0528.1983.tb06743.x.
Ninety-three placental bed biopsies containing a segment of a spiral artery at the level of the decidual-myometrial junction (53 with and 40 without physiological changes) were histologically investigated for depth of trophoblastic penetration of the uterine wall, formation of trophoblastic multinucleated giant cells and the enzyme histochemical characteristics of the interstitial (stromal) and vascular (intramural) trophoblast. The depth of trophoblastic penetration was not related to the presence or absence of the physiological changes. Conversely, in the absence of physiological changes, a significant accumulation of multinucleated giant cells at the decidual-myometrial junction was found before 36 weeks of gestation. The enzyme histochemical characteristics of the placental bed trophoblast suggest a stromal migration of trophoblast to the proximal (decidual-myometrial) part of the spiral artery whereas the distal part might be invaded by intraluminal (upstream) invasion. The hypothesis is put forward that in the absence of physiological changes a disturbed stromal migration is caused by intrinsic (trophoblastic) or extrinsic (interstitial of vascular) factors expressed by the augmentation of the multinucleated cells at the decidual-myometrial junction.
对93份胎盘床活检组织进行了组织学研究，这些活检组织包含蜕膜 - 肌层交界处一段螺旋动脉（53份有生理变化，40份无生理变化），研究内容包括滋养层穿透子宫壁的深度、滋养层多核巨细胞的形成以及间质（基质）和血管（壁内）滋养层的酶组织化学特征。滋养层穿透深度与生理变化的有无无关。相反，在无生理变化的情况下，妊娠36周前在蜕膜 - 肌层交界处发现多核巨细胞显著积聚。胎盘床滋养层的酶组织化学特征表明，滋养层向螺旋动脉近端（蜕膜 - 肌层）部分进行基质迁移，而远端部分可能受到管腔内（上游）侵袭。有人提出这样的假说：在无生理变化的情况下，蜕膜 - 肌层交界处多核细胞增多所表达的内在（滋养层）或外在（间质或血管）因素导致基质迁移紊乱。
