The Study On The Correlation Between Vascular Endothelial Growth Factor(VEGF)、Its Soluble Receptor (sFlt-1) And Incomplete Medical Abortion

Objective:To study the roles of vascular endothelial growth factor(VEGF)and its soluble receptor (sFlt-1) in medical abortion,and the correlationbetween the two factors and incomplete abortion and to provide new ideas anddirection for clinical treatment of incomplete abortion with mifepristone.Methods:One hundred and seventy-eight patients of early pregnancywho had elected abortion were studied.In which94cases with completemedical abortion and42cases with incomplete medical abortion and42women with artificial abortion.1Enzyme linked immunosorbent assay (ElISA) method was used todetect the level of maternal serum VEGF and sFlt-1before and after takingmifepristone.The level was compared between the complete abortion groupand incomplete abortion group.2Immunohistochemistry S-P method was used to analyze the expressionof VEGF and sFlt-1in villous and decidual tissues of the three groups.Usingthe percentage of positive cells and the staining intensity scoring method toanalyze the results.Results：1The results of ELISA:1.1The level of maternal serum VEGF and sFlt-1has significant differencebefore and after taking mifepristone(P<0.05).The serum concentration ofVEGF after taking mifepristone was significantly lower compared with theconcentration before taking mifepristone(t=100.40,P=0.00),they are (697.10±150.25)pg/ml vs (1012.38±190.58)pg/ml.The serum concentration of sFlt-1after taking mifepristone was significantly higher compared with theconcentration before taking mifepristone(t=181.99,P=0.00),they are (3212.45 ±251.76) pg/ml vs (2695.71±215.31)pg/ml.1.2There was significant difference of maternal serum VEGF and sFlt-1between complete abortion group and incomplete abortion group (P<0.05).VEGF levels were significantly higher in incomplete abortion groupcompared to complete abortion group(t，=27.63, P=0.00):(891.34±41.23) pg/ml vs (586.55±87.38)pg/ml,whereas there was a significant decrease in thelevels of sFlt-1(t，=27.69, P=0.00):(2887.88±68.76) pg/ml vs (3398.08±146.03) pg/ml.2The results of Immunohistochemistry:2.1Expression of VEGF and sFlt-1protein in villous and decidual tissueImmunohistochemistry results showed that VEGF and sFlt-1protein ismainly expressed in cytoplasm of decidual cells,vascular endothelialcells,gland epithelial cells and trophoblast.2.2The VEGF immunoreactivity has significant difference in three groups(P<0.05).The positive rate of VEGF protein in artificial abortiongroup,complete abortion group and incomplete abortion group were32%(27/84),15%(28/188)and67%(56/84).Compared with the completeabortion group, the artificial abortion group and incomplete abortion groupshowed stronger immunoreactivity and the difference were statisticalsignificance:(X2=10.71,P=0.00)and (X2=72.91,P=0.00).2.3The sFlt-1immunoreactivity has significant difference in three groups(P<0.05).The positive rate of sFlt-1protein in artificial abortiongroup,complete abortion group and incomplete abortion group were23%(19/84),75%(141/188)and42%(35/84).Compared with the completeabortion group, the artificial abortion group and incomplete abortion groupshowed weaker immunoreactivity and the difference were statisticalsignificance:(X2=65.77，P=0.00) and (X2=28.25，P=0.00).Conclusions：1The abnormal expression of VEGF and sFlt-1in maternal serum andvillous and decidual tissue were associated with medical abortion and may beone of the mechanisms of it. 2There is correlation between VEGF、sFlt-1and incomplete abortion,andthe abnormal expression may be one cause of incomplete abortion.