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目的:探讨多囊卵巢综合征(PCOS)患者不同组织学分期的子宫内膜白血病抑制因子(LIF)的表达与子宫内膜容受性的关系。方法:20例已婚PCOS患者(PCOS组)和26例已婚不孕症患者(对照组)在月经周期第5￣14日及排卵后7￣8 d采集其子宫内膜标本,经HE染色判定内膜组织学分期,采用免疫组织化学法检测内膜LIF的表达。结果:PCOS组间质反应不良和分泌反应欠佳的发生率均高于对照组,差异有统计学意义(χ2=5.000,P<0.05;χ2=7.219,P<0.01)。LIF的表达以腺上皮细胞的胞质为主,其在分泌中期子宫内膜的表达水平均高于增生期(P<0.01)。LIF在PCOS组增生期和分泌中期子宫内膜的表达水平均低于其相应的对照组(P<0.01)。结论:PCOS患者着床窗口期LIF的低表达可能影响着床的多个环节,参与了PCOS患者内分泌紊乱纠正后仍出现妊娠率低、流产率高的发生、发展过程。
Objective: To investigate the relationship between expression of endometrial leukemia inhibitory factor (LIF) and endometrial receptivity in patients with polycystic ovary syndrome (PCOS) at different histological stages. Methods: 20 cases of married PCOS patients (PCOS group) and 26 cases of married infertility patients (control group) were collected endometrial specimens on the 5th ~ 14th of menstrual cycle and 7 ~ 8 days after ovulation, HE staining Endometrial histological staging was determined by immunohistochemical detection of endometrial LIF expression. Results: The incidence of interstitial and poor secretion in PCOS group was significantly higher than that in control group (χ2 = 5.000, P <0.05; χ2 = 7.219, P <0.01). The expression of LIF was mainly in the cytoplasm of glandular epithelial cells, and the expression level of LIF was higher than that in proliferative phase (P <0.01). The expression of LIF in proliferative and secretory endometrium of PCOS group was lower than that of the corresponding control group (P <0.01). Conclusions: The low expression of LIF at implantation window of PCOS patients may affect many aspects of implantation. It is involved in the occurrence and development of low pregnancy rate and high abortion rate after the correction of endocrine disorders in patients with PCOS.