CTGF,TIMP-1 In Adhesive Tissue,Peritoneum,Greater Omentum Of Cesarean Section Patients With Pelvic Adhesions

ObjectiveTo investigate the roles that CTGF and TIMP-1 play in the occurrence and development of pelvic peritoneal adhesions; to explore the relationship between expression of CTGF, TIMP-1 with adhesion severity; to explore the pathophysiological mechanism of pelvic adhesion in stable conditions, and provides theoretical basis for the research of pelvic adhesions.Methods65 cesarean section patients(without other pelvic peritoneal operation) hospitalized in the Department of Gynecology, from March 2014 to October 2014 are chosen.34 cases with pelvic peritoneal adhesions as the research group and 31 cases with non-pelvic peritoneal adhesions within the same period to be the comparison group. The adhesion group patients’ need obtain tissue adhesion and peritoneum and greater omentum from lateral peritoneal cavity near Mclntosh points on the right side during surgery. The control group patients’ peritoneum and greater omentum from lateral peritoneal cavity near McIntosh points on the right side was also obtained during surgery. The expression of CTGF and TIMP-1 in adhesive tissue,peritoneums and greater omentums of cesarean section patients with pelvic peritoneal adhesions and non-pelvic peritoneal adhesions were measured by immunohistochemical staining of PV-9000 two step method.Results1.The expression of CTGF(1)The expression of CTGF in adhesive tissue were 0.30861±0.02151 in adhesion group, which were significantly higher than 0.08780±0.00666 and 0.05281±0.00526 in peritoneums and greater omentums in adhesion group and the difference was statistically significant (P<0.05).(2)The expression of CTGF in normal peritoneal were 0.08780±0.00666 in adhesion group, which were 0.08805±0.00556 in control group and the difference was no statistically significant (P>0.05).(3)The expression of CTGF in greater omentum were 0.05281±0.00526 in adhesion group, which were 0.05159±0.00326 in control group and the difference was no statistically significant (P>0.05).2.The expression of TIMP-1(1)The expression of TIMP-1 in adhesive tissue were 0.32697±0.03117 in adhesion group, which were significantly higher than 0.05041±0.00318 and 0.07230±0.00454 in peritoneums and greater omentums in adhesion group and the difference was statistically significant (P<0.05).(2)The expression of TIMP-1 in normal peritoneal were 0.05041±0.00318 in adhesion group, which were 0.04985±0.00189 in control group and the difference was no statistically significant (P>0.05).(3)The expression of TIMP-1 in greater omentum were 0.07230±0.00454 in adhesion group, which were 0.07359±0.00328 in control group and the difference was no statistically significant (P>0.05).3.In adhesion group, the expression of CTGF in adhesive tissue was positively correlated with the expression of TIMP-1(r=0.860, P<0.05).4.The expression of CTGF and TIMP-1 in adhesive tissue in severe adhesion group is higher than that in mild and moderate adhesion group,and that in moderate adhesion group is higher than that in mild adhesion group.The difference has the statistic significance(P<0.05).Conclusions1.CTGF,TIMP-1 were high expressed in patients with pelvic adhesion adhesion and low expressed in the normal peritoneum and omentun tissues.2.The abnormal expression of CTGF,TIMP-1 are involved in the formation and development of the pelvic adhesion after cesarean section.3.CTGF and TIMP-1 may through the mutual interaction take part in the formation of pelvic peritoneal adhesions.4.The expression of CTGF and TIMP-1 are related to the severity of pelvic peritoneal adhesions.