Expression Of MMP-2, MMP-7 And TIMP-1 In Adenomyosis: Correlation With Pathogenesis And Clinical Manifestation

Objectives: To investigate the roles of matrix metalloproteinase-2(MMP-2),MMP-7 and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in the pathogenesis of adenomyosis and the relationship between MMP-2,MMP-7,TIMP-1 and clinical manifestation of adenomyosis.Methods:Immunohistochemical two-step method was employed to detect the expression of MMP-2,MMP-7 and TIMP-1 in the ectopic and eutopic endometrium of 48 patients with adenomyosis (proliferative phase : 27 cases , secretory phase :21 cases) and the endometrium of 18 controls(proliferative phase : 9 cases , secretory phase : 9 cases).Results:1 .The staining intensity of MMP-2 and MMP-7 in the endometrium of secretory phase was higher than that in the endometrium of proliferative phase in control group (P<0.05).The staining intensity of TIMP-1 in the endometrium of proliferative phase was higher than that in the endometrium of secretory phase in control group (P<0.05). The staining intensity of MMP-2 and MMP-7 and TIMP-1 was no difference between proliferative phase and secretory phase in the ectopic and eutopic endometrium of adenomyosis group.2.The expression level of MMP-2 in the ectopic endometrium of adenomyosis group was higher than that in the endometrium of control group (P<0.05).The expression level of MMP-7 in the ectopic endometrium of adenomyosis group was higher than that in the endometrium of control group (P<0.01) and that in the eutopic endometrium of adenomyosis group was higher than that in the endometrium of control group (P<0.05).The expression level of TIMP-1 was no difference among the ectopic ,eutopic endometrium of adenomyosis group and control group (P<0.05).3.The ratio of MMP-2/TIMP-1 in the ectopic endometrium of adenomyosis group was higher than that in the endometrium of control group (P<0.01).The ratio of MMP-7/TIMP-1 in the ectopic endometrium of adenomyosis group was higher than that in the endometrium of control group (P<0.05).4.There was positive correlation between dysmenorrhea and the expression of MMP-2,MMP-7 and the ratio of MMP-2/TIMP-1,MMP-7/TIMP-1 in the ectopic and eutopic endometrium of adenomyosis group (P<0.01). Dysmenorrhea was correlated with TIMP-1 negatively in the ectopic endometrium of adenomyosis group (P<0.01).Conclusions:The expression of MMP-2,MMP-7 and TIMP-1 was irrespective of the phase of the menstrual cycle in the ectopic and eutopic endometrium of adenomyosis group .The expression level of MMP-2 and MMP-7 in the ectopic endometrium of adenomyosis group was higher than that in the endometrium of control group which can make the ectopic endometrium have a greater capacity to invade .The ratio of MMP-2/TIMP-1 and MMP-7/TIMP-1 in the ectopic endometrium of adenomyosis group was higher than that in the endometrium of control group which may play an important role in the pathogenesis of adenomyosis.There was positive correlation between dysmenorrhea and the expression level of MMP-2,MMP-7 and the ratio of MMP-2/TIMP-1 , MMP-7/TIMP-1 in the ectopic and eutopic endometrium of adenomyosis group. Dysmenorrhea was correlated with the expression of TIMP-1 in the ectopic endometrium of adenomyosis group negatively which can provide us a new idea to treat adenomyosis.