Expressions And Clinical Significance Of Aromatase CytochromeP450 And Cyclooxygenase-2 In Endometriosis And Adenomyosis

Objective To investigate the expressions of aromatase cytochrome p450(p450arom) and cyclooxygenase-2 (COX-2) in eutopic and ectopic endometrium ofendometriosis(EMs)and adenomyosis(AM) and their clinical significance.Methods Immunohistochemistry and reverse transcription-polymerase chain ractionwere performed to detect the expressions of protein and mRNA of P450arom and COX-2in normal endometrium,eutopic and ectopic endometrium of EMs and AM and to analyzethe correlations between P450arom and COX-2.Results 1. P450arom and COX-2 were not expressed or just weakly expressed innormal endometrium of theirs.Both enzymes were expresssd higher in eutopie and ectopicendometrium of EMs and AM than in normal endometrium(P＜0.05). Furthermore;theexpressions of P450arom and COX-2 in ectopic endometrium were both higher than ineutopic endometrium of EMs and AM(P＜0.05).There was no significant difference in theexpression of P450arom between proliferative and secretory phase of EMs and AM (P＞0.05).While the expression of COX-2 in secretory phase was higher than that inproliferative phase of normal endometrium and EMs (P＜0.05),there was no cyclicchange throughout the menstrual cycle of COX-2 in eutopic and ectopic endometrium ofAM.2. There were no correlations between the expressions of mRNA of P450arom andCOX-2 in EMs and the rAFS stage (P＞0.05).3. The expression level of P450arom mRNA and cox-2 mRNA was directlycorrelated in EMs and AM respectively; the correlation. coefficient(r)was 0.964 and 0.813respectively(P＜0.01).Conclusions 1. Proteins and mRNA of P450arom and COX-2 were over expressedin eutopic and ectopic endometrium of EMs and AM. Furthermore,the expressions of thetwo enzymes in ectopic endometrium were higher than that in eutopic endometrium bothin EMs and AM. It indicates both enzymes closely correlate with the pathogenesy of EMs and AM. The two enzymes may play an important role in the genesis and development ofEMs ad AM.2. There were no correlations between the expressions of P450arom and COX-2mRNA in EMs and the rAFS stage, rAFS stage was scored according to the extent ofdisease,adhesions and size of cyst,not including the focal activity and its pathologicfeatures. The expressions of P450arom and COX-2 mRNA represent the activity ofectopic focus,while rAFS score can't.3. The expressions of P450arom mRNA and cox-2 mRNA were both directlycorrelated in EMs and AM. The two enzymes may have synergistic effects on the genesisand development of EMs and AM. It provides a rational for clinical endocrine therapyof EMs and AM.