| Background:Endometriosis(endometriosis)is a common disease that causes infertility in women of childbearing age.Recently,it has been found that the structure and function of fallopian tubes are damaged in endometriosis.Fallopian tube plays an important role in natural conception.The normal structure and function of the fallopian tube epithelium are crucial for the formation and transportation of fertilized eggs.However,there are few studies on the ultrastructure of oviduct epithelium.Objective:To observe the effect of oviduct endometriosis on the ultrastructure of oviduct epithelium,and semi-quantitative detection of the expression of inflammatory factors and chemokines(IL-6 and CCL19/CCR7)by immunohistochemistry,to explore the changes of the ultrastructure of oviduct in endometriosis.Methods:Five patients with pathological diagnosis of endometriosis of fallopian tubes were selected as the case group,and 5 patients without fertility requiring who completed hysterectomy and fallopian tube resection were selected as the control group.Pelvic endometriosis,adenomyosis,dysmenorrhea and pelvic inflammatory diseases were excluded.All specimens were collected within 3-7 days after menstruation.The fallopian tube specimens were fixed immediately after salpingectomy and observed by SEM and TEM,and IL-6 and CCL19/CCR7 were detected by immunohistochemistry.Results:1.Under the optical microscope,the oviduct epithelium of the control group contained abundant mucosal plica,and the secretory cells had brush-like edges on the surface,and the epithelial cells were regular in morphology.Under light microscope,ectopic endometrial glands were seen in the mucosa in the case group.Inflammatory cells were seen around the ectopic endometrial glands,and secretory cells in the mucosa had incomplete brush margins.2.Under transmission electron microscope,both the epithelial and secretory cells of the oviduct of the control group contained a large number of organelles,and abundant cilia were found in the ciliated cells,with a large number of 9+2 microtubule complex structures and 9+0 structures in the basement.Microvilli are seen on the surface of secretory cells.Compared with the control group,the cilia of the ampullary epithelium of the oviduct in the case group also had 9+2 microtubule composite structure,but the content was low.There was no obvious matrix at the bottom of the ciliary epithelium,and the number of secreted cell microvilli was low.The number of ciliary cells decreased,and the top cilia decreased,with ciliary fusion.Intracellular organelles are few and contain many vacuoles.Cytoplasm electron density decreased,edema was obvious,lysosome was visible.3.Under scanning electron microscope,cilia and secretory cells were distributed on the surface of ampulla mucosa of the control group,and dense and abundant cilia were observed on the cilia cells.The direction of cilia is consistent and orderly,and there is no adhesion or lodging between cilia.The secretory cells are located between the ciliary cells,and the secretory cells are covered with short rod-like microvilli.In the case group,oviduct epithelial cells were damaged,ciliary cells and secretory cells almost completely disappeared,and a large number of collagen fibers were replaced.4.Immunohistochemical analysis showed that the expressions of inflammatory cytokines,chemokines IL-6 and CCL19 in the oviduct endometriosis group were strongly positive,which was significantly higher than that in the control group,but CCR7 was not significantly increased.Most of the inflammatory and chemokines were located in the epidermis,which may be involved in the injury of the epithelial cells of the oviduct.Conclusion:Endometriosis of the fallopian tube damages the ultrastructure of the epithelial cells of the fallopian tube,and the expression of inflammatory factors in the epithelial tissue of the fallopian tube increases,which provides a new target for the study on the infertility mechanism of endometriosis of the fallopian tube. |
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