Expression Of E-Cadherin In Human Trophoblast And Its Role In Morbidly Adherent Placenta

ObjectsE-cadherin downregulation has been regarded as the early marker of tumor progression and associates with invasive ability enhancement.The primary objective of the present study was to investigate the expression of E-cadherin in chorionic villi and it’s function in excessive trophoblast invasion.MethodsAll specimens of placental tissue were collected at Fujian Maternity and Child Health Hospital,Fujian Medical University Teaching Hospital for delivery from December 2013 to October 2014.The study included 20 patients with morbidly adherent placenta were divided into the placenta accreta group(n=10;accreta,n=6;increta,n=4) and the placenta previa group(n=10) with 10 normal pregnancy served as control.In the placenta accreta group,the placenta drawn from the same patient were divided into the invasive area,the edge of the invasive area and the noninvasive area according to different sites of material;in the placenta previa and the control group,the placenta drawn from the same patient were divided into the placental central zone,placental edge of the upper zone and placenta edge of the lower zone according to different sites of material(edge of the placenta near the cervix defined as below,the opposite defined as upper zone). Immunohistochemistry, Western-blot and RT-PCR techniques were used to detect the placenta E- cadherin expression in placenta previa,placenta accreta and normal pregnancy maternal surface.Result1.The MAP(PP and PA) group compared with the control group have longerhospital stay [(13.1±8.9) d and(7.7±2.58) d vs(5.8±1.99) d,P<0.05],more bleeding [(2991.40±3055.37) ml and(916.40±701.95) ml vs(381.00±72.20) ml,P<0.05] and more hospital costs [(28972.27±18599.40) RMB and(12651.84±2970.85) RMB vs(7452.64±1927.85) RMB,P<0.05].The difference was not statistically significant between the three groups in placental weight [(605.30±78.22) g and(641.00±87.55) g vs(644.00±62.08) g,P>0.05] and the child birth weight [(3053.50±664.97) g and(3116.50±516.52) g vs(3287.50±229.77) g,P>0.05].2.Immunohistochemistry showed in the MAP(PP and PA) group,trophoblastic connections between cells were significantly reduced compared with the normal placental trophoblast cells. In the chorionic villi of invasive placenta accreta tissues,the E-cadherin expression was significantly lower than that in noninvasive tissues.3.Western-blotting and RT-PCR revealed that the level of E-cadherin expression was significantly lower in the MAP group {PP [(0.409±0.0292) and(0.628±0.264)] and PA [(0.406±0.0312) and(0.557±0.123)]} compared with the control group [(0.409±0.0292) and(0.628±0.264)](P<0.05);whereas there was no significant difference between PP and PA(P>0.05).4.Western-blotting and RT-PCR revealed that the level of E-cadherin expression in the chorionic villi of invasive placenta accreta tissues were [(0.397±0.0395) and(0.415±0.0927)],which was significantly lower than that in noninvasive tissues [(0.417±0.0472) and(0.738±0.144)](P<0.05).5.Western-blotting and RT-PCR revealed that the level of E-cadherin expression in the PP group were placental edge of the upper zone [(0.414±0.0363) and(0.723±0.371)],placental central zone [(0.408±0.0429) and(0.506±0.252)],placental edge of the lower zone [(0.406±0.0370) and(0.656±0.277)],there were no significant difference between the three sites(P>0.05).6.Western-blotting and RT-PCR revealed that the level of E-cadherin expression in the control group were placental edge of the upper zone [(0.619±0.0209) and(1.00)],placental central zone [(0.611±0.0396) and(0.843±0.433)],placental edge of the lower zone [(0.598±0.0280) and(0.706±0.277)],there were no significant difference between the three sites(P>0.05).7.Western-blotting and RT-PCR revealed that the level of E-cadherin expression in placenta increta [(0.378±0.0232) and(0.436±0.0423)] was significantly lower than placenta accreta [(0.425±0.0193 and(0.605±0.0961)](P<0.05).Conclusion1. E-cadherin expression was significantly lower in the MAP(PP and PA) group compared with the control group;whereas there was no significant difference between PP and PA.The E-cadherin expression was significantly lower than that in noninvasive tissues.The level of E-cadherin expression in placenta increta was significantly lower than placenta accreta.2. These findings strongly suggest that E- cadherin plays an important role in pathogenesis of morbidly adherent placenta.With negative associated with the degree of placental invasion.3. Decidua may involve in the regulation of the trophoblast E- cadherin expression.