Study On The Expression Of TGF-β1,CTGF And VEGF In Uterine Decidua Of Patients With Cesarean Section Scar Pregnancy

Objective:To investigate the biological mechanism of cesarean section scar and the related biomarkers of cesarean section scar healing,the expression of transforming growth factor-β 1(transforming growth factor-β 1,TGF-β 1),connective tissue growth factor(connective tissue growth factor,CTGF)and vascular endothelial growth factor(vascular endothelial growth factor,VEGF)in uterine decidua of cesarean scar pregnancy(cesarean scar pregnancy,CSP)and normal pregnancy after cesarean section were detected.The purpose of this study is to find the pathogenesis of CSP and to provide some basic theoretical basis for the clinical prevention and treatment of CSP.Methods:From January 2020 to December 2020,30 cases of decidual tissue in CSP group and 30 cases of normal pregnancy group after cesarean section were collected in the affiliated Hospital of Guizhou Medical University.Samples of decidual tissue from cesarean section scar and uterine cavity were collected in each group.Both groups were early pregnancy(≤12 weeks).TGF-β 1,CTGF and VEGF in paraffin sections of uterine decidual tissue from cesarean section scar and uterine cavity were marked by immunohistochemical method.The expressions of TGF-β 1,CTGF and VEGF were detected.Results:1.Comparison of TGF-β1 expression levels in the decidual tissues of the two groups: the expression level of TGF-β1 in the decidual tissues of the CSP group was higher than that in the uterine cavity tissues and the normal pregnancy group(P<0.05);There was no significant difference between the expression of TGF-β1 in cicatoid decidua tissue and that in uterine decidua tissue between normal pregnancy group and cesarean section group(P>0.05).There was no significant difference between CSP group and normal pregnancy group in the expression of TGF-β1 in decidual tissue(P>0.05).2.Comparison of the expression level of CTGF in the decidual tissue of the two groups: the expression level of CTGF in the decidual tissue from cesarean section scar of CSP group was higher than that in uterine cavity and the normal pregnancy group(P<0.05);There was no significant difference in the expression of CTGF between decidua tissue and uterine cavity decidua tissue of normal pregnancy group(P>0.05).There was no significant difference in CTGF expression level between CSP group and normal pregnancy group(P>0.05).3.Comparison of the expression of VEGF in the decidual tissue of the two groups: there was no significant difference in the expression of VEGF between the scar decidual tissue and uterine cavity decidual,and the same between the CSP group and the normal pregnancy group(P>0.05);There was no significant difference in the expression level of VEGF between scar decidual tissue and uterine decidual tissue in normal pregnancy group(P>0.05).There was no significant difference in the expression of VEGF in the decidua tissus of uterine cavity between CSP group and normal pregnancy group(P>0.05).4.Correlation between TGF-β1 and CTGF,TGF-β1 and VEGF expression in decidual tissue: TGF-β1 and CTGF expression were positively correlated(r=0.625,P<0.05),but TGF-β1 and VEGF expression were not correlated(r=-0.077,P>0.05).Conclusions:The expression levels of TGF-β1 and CTGF in decidual tissue of cesarean section scar in CSP group were higher than those in normal pregnancy group after cesarean section,and also higher than those in intrauterine decidual tissue.There was no significant difference in VEGF expression levels between CSP group and normal pregnancy group after cesarean section and the intrauterine decidual tissue.Therefore,we speculated that the high expression of TGF-β1 and CTGF in scar decidual tissue after cesarean section may play an important role in the pathogenesis of CSP.