Khong T Y, Abdul Rahman H
Department of Histopathology, Women's and Children's Hospital, North Adelaide, Australia.
Int J Gynecol Pathol. 1997 Apr;16(2):138-42. doi: 10.1097/00004347-199704000-00009.
In subinvolution of the placental bed, the uteroplacental (spiral) arteries that had undergone physiologic changes to accommodate the needs of the placenta and fetus during pregnancy fail to involute and avert to their nonpregnant state. Because expression of bcl-2 oncoprotein is associated with inhibition of apoptosis and prolonged cell survival, we examined its expression in third-trimester human placental bed tissue and in uterine tissue from women presenting with postpartum hemorrhage in which a diagnosis of involution or of subinvolution of the placental bed was made. bcl-2 oncoprotein was not detected in the uteroplacental arteries during the third trimester of pregnancy but was seen in involution and, more strongly, in subinvolution of the placental bed. Extravillous trophoblast was weakly stained in pregnancy and in the postpartum specimens, whereas glandular epithelium was stained to a variable degree and intensity. The findings suggest that involution and subinvolution of the placental bed are morphologic entities that lie in the spectrum between complete resolution and noninvolution of pregnancy-induced changes and that bcl-2 is associated with subinvolution of the uteroplacental arteries.
在胎盘床复旧不全时，孕期为满足胎盘和胎儿需求而发生生理性改变的子宫胎盘（螺旋）动脉未能复旧，无法恢复到非孕状态。由于bcl-2癌蛋白的表达与细胞凋亡抑制及细胞存活时间延长有关，我们检测了其在孕晚期人胎盘床组织以及因产后出血就诊且已诊断为胎盘床复旧或复旧不全的女性子宫组织中的表达。在妊娠晚期的子宫胎盘动脉中未检测到bcl-2癌蛋白，但在胎盘床复旧及更明显的复旧不全时可检测到。妊娠及产后标本中的绒毛外滋养层染色较弱，而腺上皮染色程度和强度各异。这些发现提示，胎盘床复旧和复旧不全是介于妊娠所致改变完全消退和未消退之间的形态学实体，且bcl-2与子宫胎盘动脉复旧不全有关。
