Expression and Significance of TGF - β 1，TIMP-1 and Collagen Ⅲ in Vaginal Wall of Patients with Pelvic Organ Prolapse
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摘要:
目的 探讨TGF-β1、TIMP-1及Collagen Ⅲ在盆腔器官脱垂患者阴道壁中的表达及意义。 方法 选取2020年3月至2020年12月在昆明医科大学第一附属医院妇科住院部手术的盆腔器官脱垂（pelvic organ prolapse，POP）患者28例为实验组，其中按POP-Q分期法将其分为：II度7例，Ⅲ度16例，IV度5例。选择同期因妇科良性病变行全子宫和（或）双附件切除且无POP患者30例为对照组。通过免疫组化的方法检测阴道壁组织中TGF-β1、TIMP-1及Collagen Ⅲ的表达。 结果 POP组的TGF-β1、TIMP-1及Collagen Ⅲ的IRS得分明显低于对照组，差异有统计学意义（P < 0.05）；POP组II度、Ⅲ度及Ⅳ度患者的TGF-β1、TIMP-1及Collagen Ⅲ的IRS得分随着分度的增加呈逐渐降低的趋势，差异均有统计学意义（P < 0.05）。POP组患者阴道壁组织中Collagen Ⅲ与TIMP-1、TGF-β1表达呈正相关（r = 0.381，0.519，P < 0.05）；TGF-β1表达与TIMP-1表达呈正相关（r = 0.270，P < 0.05）。 结论 POP患者阴道壁组织中Collagen Ⅲ、TIMP-1和TGF-β1呈低表达，且与病情程度有一定的关系，可能参与POP的发生、发展；POP患者阴道壁组织中Collagen Ⅲ、TIMP-1、TGF-β1间存在一定相关性，三者之间存在一定的协同作用，共同参与疾病的发生发展。 -
关键词:
- 转化生长因子-β1 /
- 组织基质金属蛋白酶抑制物-1 /
- III胶原蛋白 /
- 盆腔器官脱垂
Abstract:Objective To investigate the expression and significance of TGF-β1, TIMP-1 and Collagen Ⅲ in the vaginal wall of patients with pelvic organ prolapse （POP）. Methods A total of 28 POP patients who underwent surgery in the Department of Gynecology of the First Affiliated Hospital of Kunming Medical University from March 2020 to December 2020 were selected as the POP group, which were divided into 7 cases of grade Ⅱ, 16 cases of grade Ⅲ, and 5 cases of grade Ⅳ according to POP-Q staging method. Thirty patients with complete hysterectomy and/or bilateral adnexectomy without POP due to gynecological benign lesions were selected as the control group. The expressions of TGF-β1, TIMP-1 and Collagen Ⅲ in vaginal wall tissue were identified by immunohistochemistry. Results The IRS score of TGF-β1, TIMP-1 and Collagen Ⅲ in the POP group were significantly lower than those in the control group, with the statistical significance （P < 0.05）. The IRS scores of TGF-β1, TIMP-1 and collagen Ⅲ in patients with grade Ⅱ, grade Ⅲ and grade Ⅳ in the POP group gradually decreased with the increase of degree, and the differences were statistically significant （P < 0.05）. There was a positive correlation between TIMP-1 and TGF-β1 expression in the vaginal wall tissue of the POP group （r = 0.381, 0.519, P < 0.05）. TGF-β1 expression was positively correlated with TIMP-1 expression （r = 0.270, P < 0.05）. Conclusion Collagen Ⅲ, TIMP-1 and TGF-β1 are low expressed in vaginal wall tissue of pop patients, which may be involved in the occurrence and development of pop, and may be correlated with the severity of the disease. Collagen Ⅲ, TIMP-1 and TGF-β1 in the vaginal wall tissue of pop patients are correlated to some extent, and they have a certain synergistic effect, jointly participating in the occurrence and development of the disease. -
图 1 2组TGF-β1、TIMP-1及Collagen Ⅲ的免疫组化图（SP，×200）
a：POP组阴道壁组织TGF-β1的免疫组织化学染色图；b：对照组阴道壁组织TGF-β1免疫组织化学染色图；c：POP组阴道壁组织TIMP-1的免疫组织化学染色图；d：对照组阴道壁组织TIMP-1免疫组织化学染色图；e：POP组阴道壁组织Collagen Ⅲ的免疫组织化学染色图；f：对照组阴道壁组织Collagen Ⅲ免疫组织化学染色图。
Figure 1. Immunohistochemistry of the two groups of TGF-β1，TIMP-1 and Collagen Ⅲ（SP，×200）
图 2 POP组Collagen Ⅲ与TIMP-1的关系
Figure 2. The relationship between collagen Ⅲ and TIMP-1 in the POP group
图 3 POP组Collagen Ⅲ与TGF-β1的关系
Figure 3. The relationship between collagen Ⅲ and TGF-β1 in the POP group
图 4 POP组TIMP-1与TGF-β1的关系
Figure 4. The relationship between TIMP-1 and TGF-β1 in the POP group
表 1 2组研究对象的基本特征对比[（
$\bar x \pm s$ ）/n （%）/M （P25，P75）]Table 1. Comparison of basic characteristics of the two groups of research objects[（
$\bar x \pm s$ ）/n （%）/M （P25，P75）]特征 POP组（n = 28） 对照组（n = 30） t/χ2/Z P 年龄（岁） 56.29 ± 10.18 51.83 ± 7.45 1.890 0.065 BMI（kg/m2） 23.47 ± 2.89 23.78 ± 2.63 −0.432 0.668 绝经情况 是 18（64.3） 14（46.7） 0.003 0.956 否 10（35.7） 16（53.3） 产次（次） 2（1.25，2.75） 2（1，2） −1.449 0.147 
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表 2 2组TGF-β1、TIMP-1及Collagen Ⅲ的表达情况（
$\bar x \pm s$ ）Table 2. The expression of TGF-β1，TIMP-1 and Collagen Ⅲ between the two groups（
$\bar x \pm s$ ）分组 n TGF-β1 TIMP-1 Collagen Ⅲ POP组 28 1.47 ± 0.79 1.59 ± 1.11 1.93 ± 1.30 对照组 30 2.64 ± 1.42 3.85 ± 2.19 4.78 ± 2.19 t −6.094 −4.998 −6.094 P 0.000 0.000 0.000* *P < 0.05。
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表 3 POP组TGF-β1的表达与POP-Q分期的关系（
$\bar x \pm s$ ）Table 3. The relationship between the expression of TGF-β1 and POP-Q stage in POP group （
$\bar x \pm s$ ）分组 n 均数 ± 标准差 F检验 F P Ⅱ度 7 2.17 ± 0.75 7.638 0.003* Ⅲ度 16 1.39 ± 0.63 Ⅳ度 5 0.72 ± 0.53 *P < 0.05。
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表 4 POP组TIMP-1的表达与POP-Q分期的关系（
$\bar x \pm s$ ）Table 4. The relationship between the expression of TIMP-1 and POP-Q stage in POP group （
$\bar x \pm s$ ）分组 n 均数 ± 标准差 F检验 F P Ⅱ度 7 2.81 ± 1.29 9.381 0.001* Ⅲ度 16 1.23 ± 0.67 Ⅳ度 5 1.00 ± 0.75 *P < 0.05。
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表 5 POP组Collagen Ⅲ的表达与POP-Q分期的关系（
$\bar x \pm s$ ）Table 5. The relationship between the expression of collagen Ⅲ and POP-Q stage in POP group （
$\bar x \pm s$ ）分组 n 均数 ± 标准差 F检验 F P Ⅱ度 7 3.26 ± 1.13 10.936 0.000* Ⅲ度 16 1.74 ± 1.00 Ⅳ度 5 0.66 ± 0.61 *P < 0.05。
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