Quantitive Analysis On Expressions Of ER, PR And Aromatase In Abdominal Wall Endometriosis

BackgroundEndometriosis are common diseases in reproductive women, which affect between5and10percents of female people, with destructive influence. Endometriosis, with malignant biological behaviors such as proliferation, invasion, recurrence, metastasis, and so on, which can invade anywhere of body, do great harm to people’s health. Researchers have been interested in the pathogenesis since it was described. Some theories have been proposed to explain the pathogenesis of endometriosis:transplantation of endometrial tissue, celomic metaplasia, induction hypothesis and so on. No single theory, however, can account for the etiopathogenesis. Endometriosis is an estrogen-dependent disorder, which means that ectopic tissue can hardly grow without stimulation of estrogen. We mainly cure this disease through inhibiting or antagonizing the function of estrogen, nevertheless the effect is unsatisfying. As for the reasons, some researchers suppose that ectopic tissue may produce estrogen itself. Aromatase plays a key role in the synthesizing of estrogen, and what’s more, many cases about successfully healing endometriosis with Aromatase inhibitors are reported in other countries. Its effect of abdominal wall endometriosis has rarely been studied so far. Therefore, exploring the expression of Aromatase in these diseases may help us to know the disease more clearly, in order to develop a new target of the therapy.Objectives1. To observe the expression of Aromatase, ER, PR in eutopic endometrium of normal control group, abdominal wall endometriosis group and ovarian endometriosis group. Find out the differences of the expression of Aromatase, ER, PR in eutopic endometrium between normal control group, abdominal wall endometriosis group and ovarian endometriosis group.2. To observe the expression of Aromatase, ER, PR in ectopic sites of abdominal wall endometriosis group and ovarian endometriosis group. Compare them with that of eutopic endometrium, to infer the regulation of reproductive hormones in ectopic sites. Materials&methodsPick up patients with ovarian endometriosis (15cases), abdominal wall endometriosis (21cases), and normal control condition (15cases) who have accepted operative treatment during June2003to January2010in Shanghai First Maternity and Infant Health Hospital. By immunohistochemical methods, we assessed their expression of Aromatase, ER, PR in eutopic and ectopic endometrium, the degree of expression were tested by the Image-Pro Plus system.Results一、The expression of Aromatase, ER, PR in ectopic endometrium of normal control group, abdominal wall endometriosis group and ovarian endometriosis group.1. The expression of ER. ER was expressed in the ectopic endometrium in all of the three groups with no significantly distinction between the proliferative phase and the secretive phase. Expressions of normal endometriosis were statistically higher than ovarian endometrium and abdominal wall endometriosis, respectively.2. The expression of PR. PR was expressed in the ectopic endometrium in all of the three groups with no significantly distinction between the proliferative phase and the secretive phase. Expressions of normal endometriosis were statistically higher than ovarian endometrium and abdominal wall endometriosis, respectively.(二、The expression of ER, PR in ectopic and eutopic sites of abdominal wall endometriosis1. The Density mean of ER were0.2359±0.0768,0.2324±0.0641Expressions of ectopic endometrium were statistically higher than eutopic endometrium.2. The Density mean of PR were0.2324±0.0648,0.2813±0.0849. Expressions of ectopic endometrium were statistically higher than eutopic endometrium.三、The expression of ER, PR in abdominal wall endometriosis group, ovarian endometriosis group and normal control group1. Abdominal wall endometriosis group and normal control group expressed no aromatase in ectopic endometrium, and ectopic tissue of ovarian endometriosis group showed positive expression of aromatase.2. Expression of aromatase was detected in eutopic site of ovarian endometriosis, while the other two groups showed negative expression. Conclusions:1. There was no expression of Aromatase in normal people, as well as the eutopic and ectopic endometrium of Abdominal Wall Endometriosis, while the eutopic and ectopic endometrium of Abdominal Wall express Aromatase. The difference in the expression of Aromatase indicates that Abdominal Wall Endometriosis and ovarian endometriosis involved in different etiopathogenesis, even if they are both grouped in endometriosis.2. The down-regulation in the expression of ER in ectopic tissue of Abdominal Wall Endometriosis was lower than ovarian endometriosis and normal control group, which indicates that the mechanism and biological characteristics of AWE were different from the other types of endometriosis. This may results from local fibrosis of ectopic endometrium in Abdominal Wall Endometriosis.3. The expression of PR in ectopic endometrium of Abdominal Wall Endometriosis and ovarian endometriosis than normal endometrium, the regulation of PR in Abdominal Wall Endometriosis group was decreased than ovarian endometriosis group, which might be the biological foundation for no so good curative effect in medical practices with progesteroid medicine in treating Abdominal Wall Endometriosis.4. There were Aromatase expression in ectopic and eutopic endometriosis of abdominal wall endometriosis, with low expression in ER and PR, which implies that whether there were relationship between the development of abdominal wall endometriosis and eutopic endometrium needs to be further discussed. Transplantation of endometrial tissue is more likely accounts for the development of abdominal wall endometriosis.