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目的观察子宫腺肌病(Adenomyosis,ADS)子宫与正常子宫不同解剖部位平滑肌细胞生长与增殖状态的差异。方法收集2014年6月至2015年6月于首都医科大学附属北京妇产医院妇科微创中心因ADS行子宫切除的标本14例为ADS组,选取同期因宫颈上皮内瘤变(cervical intraepithelial neoplasias,CIN)Ⅲ或早期宫颈癌切除的子宫标本15例为对照组。原代培养子宫内膜-肌层交界区(endometrialmyometrial interface,EMI区)与子宫外周肌层(outer myometrium,OM)平滑肌细胞,显微镜下观察细胞形态特性,采用CCK8法检测细胞生长活力,流式细胞术检测细胞周期,分析细胞增殖情况。结果 1子宫EMI区与OM平滑肌细胞形态有明显差异,EMI区细胞多呈长梭形,OM细胞多呈菱形且倾向于成簇生长;EMI区细胞“峰-谷”特点和结节形成现象比OM细胞显著。2 ADS组EMI区细胞生长旺盛,高于ADS组OM细胞和对照组EMI区细胞的生长活力。3 ADS组在EMI区的平滑肌细胞G2+S期比例为24.35%±2.51%,高于OM区细胞比例(21.04%±1.27%),EMI区细胞增殖能力比OM区显著增强(P<0.05);EMI区平滑肌细胞在ADS组的G2+S期比例为24.35%±2.51%,高于对照组细胞(20.72%±1.28%)(P<0.05)。结论ADS患者EMI区细胞生长状态和增殖能力旺盛,可能是影响腺肌病发生发展的形态学基础。
Objective To observe the difference of proliferation and proliferation of smooth muscle cells in different anatomical parts of uterus and normal uterus of adenomyosis (Adenomyosis). Methods Fourteen cases of ADS hysterectomy from June 2014 to June 2015 in Beijing Gynecological and Obstetrics Hospital of Capital Medical University were enrolled in this study. The ADS group was selected. Cervical intraepithelial neoplasias CIN) Ⅲ or early cervical cancer resection of 15 cases of uterine specimens for the control group. Primary cultured endometrial myometrial interface (EMI area) and the outer myometrium (OM) smooth muscle cells, observed under a microscope cell morphology characteristics, cell viability by CCK8 assay, flow cytometry Surgery was used to detect the cell cycle and analyze cell proliferation. RESULTS: There was a significant difference in morphology between the uterine EMI area and the OM smooth muscle cells. Most of the cells in the EMI area were fusiform in shape, while the OM cells were mostly diamond-shaped and tended to cluster. The characteristics of the cells in the EMI area and the nodules Phenomenon than OM cells significantly. 2 ADS group EMI area cell growth is vigorous, higher than the ADS group of OM cells and the control group of cells in the area of growth and vitality. The ratio of G2 + S phase in smooth muscle cells of ADS group was 24.35% ± 2.51%, which was higher than that in OM area (21.04% ± 1.27%). The proliferative capacity of EMI in the EMI area was significantly higher than that in OM area (P <0.05) ; The percentage of G2 + S phase in the ADS group was 24.35% ± 2.51% in the EMI zone, which was higher than that in the control group (20.72% ± 1.28%) (P <0.05). Conclusion The cell growth status and proliferative capacity of the patients with ADS are strong and may be the morphological basis for the development of adenomyosis.