title: Research on the expression of integrin β3 and leukaemia inhibitory factor in the decidua of women with cesarean scar pregnancy.
abstract: Cesarean scar pregnancy (CSP) is a late serious complication of cesarean section. There has been an increase in the incidence of CSP worldwide in recent years. It's a life-threatening condition because of the high risk of uncontrolled hemorrhage and uterine rupture. The mechanism of CSP is still unclear. The endometrial receptivity might be different in the cesarean scar between CSP and normal pregnancies. Endometrial expression of integrin β3 and LIF positively correlates with endometrial receptivity and embryo implantation. The purpose of the study is to explore the mechanism of CSP.
  
  
  
  The EnVision two-step immunohistochemical staining technique was used to detect the expression of integrin β3 and LIF in the decidua of women with CSP (20 cases) and normal pregnancies (20 cases). The distribution and staining intensity of integrin β3 and LIF in the two groups were observed. Observation of the staining were done using microscope within five randomly selected high-power fields (HPF, 10 × 40). All data analyses were conducted with SPSS 17.0 and the statistical significance was set at P <0.05.
  
  
  
  The decidua in the different parts of both two groups that stained with the anti-integrin β3 and anti-LIF antibody: most of the integrin β3 and LIF positive cells were located in glandular epithelium. The expression intensity of integrin β3 in the cesarean scar in CSP group was significant higher than the uterine cavity in CSP group and the cesarean scar in normal pregnancy group. It's similar with the uterine cavity in normal pregnancy group. The expression intensity of LIF in the cesarean scar in CSP group was significant higher than the uterine cavity in CSP group and the cesarean scar in normal pregnancy group. It's significant lower than the uterine cavity in normal pregnancy group.
  
  
  
  The decidual integrin β3 and LIF might play an important role in the mechanism of CSP. The increase expression of integrin β3 and LIF in the cesarean scar decidua might be associated with embryo implantation in cesarean scar. The occurrence of CSP might be related to the changes of endometrial receptivity in local cesarean scar.
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China.
authors.forename: Zhi-Da
authors.initials: ZD
authors.lastname: Qian
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Weng
authors.affiliation: Maternal and Child Health Institute of Lin'an City, 25 Jiangnan Road, Lin'an, Zhejiang Province, 311300, People's Republic of China.
authors.forename: Chun-Fen
authors.initials: CF
authors.lastname: Wang
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Huang
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China. fbzhuxiaoming@163.com.|Key Laboratory of Reproductive Genetics (Hangzhou, Zhejiang University), Ministry of Education, Hangzhou, People's Republic of China. fbzhuxiaoming@163.com.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Zhu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix; D003656:Decidua / Q000378:metabolism*; D010064:Embryo Implantation / Q000502:physiology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053605:Leukemia Inhibitory Factor / Q000378:metabolism*; D009687:Nuclear Proteins / Q000378:metabolism*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology / Q000378:metabolism*; D014599:Uterus / Q000378:metabolism
chemical_list: C403295:ITGB3BP protein, human; C507837:LIF protein, human; D053605:Leukemia Inhibitory Factor; D009687:Nuclear Proteins
keywords: Cesarean scar pregnancy; Decidua; Endometrial receptivity; Integrin; Leukaemia-inhibitory factor