Fibrillin-1、Fibulin-5及LOXL-1在盆底器官脱垂患者阴道前壁组织中的表达及意义

Expression and significance of Fibrillin-1, Fibulin-5 and lysyl-oxidase-1 on the anterior vaginal wall in patients with pelvic floor organ prolapse

摘要:

目的： 探讨原纤维蛋白-1（Fibrillin-1）、纤维蛋白-5（Fibulin-5）及类赖氨酰氧化酶-1（lysyl-oxidase-1，LOXL-1）在盆底器官脱垂（pelvic organ prolapse，POP）患者阴道前壁组织中的表达及意义。方法： 选取2018年1月至2019年2月在海南省妇幼保健院手术治疗的盆底器官脱垂患者108例作为观察组，其中POP-QⅡ度患者67例，POP-QⅢ度患者41例；同时选取因宫颈上皮内瘤变或妇科良性病变行子宫全切术患者92例作为对照组。术中均取阴道前壁组织，采用免疫组化法检测组织Fibrillin-1、Fibulin-5、LOXL-1蛋白表达情况，RT-PCR定量检测Fibrillin-1、Fibulin-5、LOXL-1 mRNA在组织标本中的表达水平，并进行对比分析。同时分析盆底器官脱垂患者阴道前壁组织中Fibrillin-1、Fibulin-5、LOXL-1表达的关系。结果： 观察组阴道组织Fibrillin-1、Fibulin-5、LOXL-1蛋白阳性表达率及mRNA的相对表达量均明显低于对照组，经卡方检验及t检验，差异均有统计学意义（均P=0.000）；POP-QⅡ度患者阴道前壁组织Fibrillin-1、Fibulin-5、LOXL-1蛋白阳性表达率及mRNA的相对表达量均高于POP-QⅢ度患者，经卡方检验及t检验，差异均有统计学意义（P=0.031，P=0.017，P=0.008，P=0.000，P=0.000，P=0.013）。POP患者阴道前壁组织Fibrillin-1与Fibulin-5、Fibrillin-1与LOXL-1、Fibulin-5与LOXL-1蛋白表达及mRNA的相对表达量经Spearman秩相关及Pearson相关分析均呈显著正相关（均P=0.000）。结论： 盆底器官脱垂患者阴道组织Fibrillin-1、Fibulin-5及LOXL-1表达降低，且均与脱垂程度密切相关，三者间通过交联作用而呈显著相关性。

Abstract:

Objective: To investigate the expression and significance of Fibrillin-1, Fibulin-5 and lysyl-oxidase-1 (LOXL-1) on the anterior vaginal wall in patients with pelvic floor organ prolapse. Methods: A total of 108 patients with pelvic floor organ prolapse who underwent surgery in our hospital from January 2018 to February 2019 were selected as the observation group, including 67 patients with POP-Q ofⅡdegree and 41 patients with POP-Q ofⅢdegree. At the same time, 92 patients with cervical intraepithelial neoplasia or gynecological benign lesions who underwent total hysterectomy were selected as the control group. The tissue of anterior vaginal wall was taken. The expression of Fibrillin-1, Fibulin-5 and LOXL-1 was detected by immunohistochemistry; the expression level of Fibrillin-1, Fibulin-5 and LOXL-1 mRNA in the tissue samples were quantitatively measured by RT-PCR, and then were compared and analyzed. Meanwhile, the relationship of Fibrillin-1, Fibulin-5 and LOXL-1 was analyzed. Results: The positive expression rate of Fibrillin-1, Fibulin-5 and LOXL-1 in the observation group was significantly lower than that in the control group, and the difference had statistical significance according to chi-square test and t test (all P=0.000). The positive expression rate Fibrillin-1, Fibulin-5 and LOXL-1 protein and the relative expression of mRNA in patients with POP-Q ofⅡdegree were higher than those in patients with POP-Q ofⅢdegree, and the difference had statistical significance by chi-square test and t test (P=0.031, P=0.017, P=0.008, P=0.000, P=0.000, P=0.013, respectively). The expression of Fibrillin-1 and Fibulin-5, Fibrillin-1 and LOXL-1, and Fibulin-5 and LOXL-1, and relative mRNA expression in the anterior vaginal wall of POP patients were significantly positively correlated according to Spearman rank correlation and Pearson correlation (all P=0.000). Conclusion: The expression of Fibrillin-1, Fibulin-5 and LOXL-1 in vaginal tissues of patients with pelvic floor organ prolapse is decreased, which is closely related to the degree of prolapse, and the correlation among them is significant through the cross linking.