| ObjectiveThe elevated expression of Snail is a marker of tumor progression, which is related to the invasion of tumor cells. The objective is to study the expression of Snail in placenta accreta and placenta previa, and to explore the relationship between the expression of Snail and the invasion of placental trophoblast cells in case of placenta accreta.MethodsCases of pregnant women with regular prenatal examination and cesarean delivery were selected from November 2015 to January 2015 in Fujian Maternity and Child Health Hospital. 10 cases diagnosed with placenta accreta and 20 cases diagnosed with placenta previa clinically and pathologically were selected as PA group and PP group.30 cases underwent cesarean cesarean due to scar uterus, abnormal fetal position and social factors were selected as CG group. PA group was then divided into central region of implantation and non implantation area edges according to different sampling sites.PP group and CG group were divided into the corresponding area for attachment of the umbilical cord root and placental marginal area according to different sampling sites.Snail was positioned by immunohistochemistry in placenta. The expression level of Snail was analyzed by Western-blot. The expression level of Snail mRNA was analyzed by real-time quantitative PCR.Results1 Comparison of three groups of patients with clinical situation: The age, the times of abortion, the number of pregnancies and the cost of PA and PP group were higher than that of CG group, the difference was statistically significant(P<0.05). The gestational age of PA and PP group were less than CG group, the difference was statistically significant(P<0.05). The fetal weight of PA group was less than CG group,the length of hospital stay and blood loss were greater than that of CG group, the difference was statistically significant(P<0.05). In PA and PP group, the number ofdeliveries was higher than that of CG group, and the placental weight was less than CG group, the difference was not statistically significant(P>0.05). The number of uterine surgery in group PA was more than that in group CG, the difference was not statistically significant(P>0.05). The fetal weight of PP group was less than CG group, the difference was not statistically significant(P>0.05).2 Immunohistochemical results showed PA, PP and CG group are positive i n Snail expression.3 Compare the level of placental Snail protein among 3 groups. The level of PA,PP and CG group were respectively(1.01±0.20),(0.9±0.17) and(0.53±0.13). The level of PA and PP group were higher than CG group, the differences were statistically significant(P<0.05). The level of PA group was higher than PP group, the difference was not statistically significant(P>0.05).4 Compare the level of placental Snail mRNA among 3 groups. The level of PA,PP and CG group were respectively(0.93±0.61),(0.74±0.23) and(0.74±0.19). The level of PA group was higher than CG group. The differences was statistically significant(P<0.05). The difference between PP and CG group and the difference between PA and PP group was not statistically significant(P>0.05).5 Compare the expression of Snail in different sites of placenta in PA group. The level of placental Snail protein in invasive part and noninvasive part were respectively(1.01±0.26) and(1.00±0.13), and the difference was not statistically significant(P>0.05). The level of Snail mRNA in invasive part and noninvasive part were respectively(1.10±0.80) and(0.76±0.30), and the difference was not statistically significant(P>0.05).6 Compare the expression of Snail in different sites in PA and CG group. The level at the root of umbilical cords and the edges of placenta in PP group were respectively(0.88±0.16) and(0.89±0.10), The value of the root of umbilical cords and the edges of placenta in CG group were respectively(0.53±0.13) and(0.53±0.08), the difference was not statistically significant(P>0.05). The level of Snail mRNA of the root of umbilical cords and the edges of placenta in PP group were respectively(0.75±0.29) and(0.74±0.16), The value of the root of umbilical cords and the edges of placenta in CG group were respectively(0.74±0.23) and(0.73±0.15), and the difference was not statistically significant(P>0.05).Conclusion1 The expression of Snail was significantly increased in placenta accreta and placenta previa.2 Over expression of Snail in placenta is positively related to the invasiveness of placental trophoblast cells, and it was involved in the incidence of placenta accreta.3 Up regulation of the expression of Snail in placenta may promote placenta accreta by pushing EMT. |
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