The Expression Of KGF And ER α In The Endometrium Of Patients With Intrauterine Adhesion And The Clinic Study Of Intrauterine Adhesions

Objective:To analyse the etiology of intrauterine adhesions, clinical characteristics, evaluate the efficiency of transcervical resection of adhesions and the prognosis of reproduction and to observe the expression of keratinocyte growth factor (KGF) and estrogen receptor a (ER a) in the endometrium of patients with intrauterine adhesion, analysis the function of KGF and ER a in endometrial injury repair.Materials and methods:This retrospective clinical study analyzed259patients with IUA who underwent transcervical resection of adhesions. A total of76patients with IUA and30patients of normal uterine shape were enrolled. Immunohistochemistry was used to detect the differential expression of KGF and ER a in the106cases.Results:1. The possible cause of IUA was previous curettage on gravid uterus (89.6%), The severity of intrauterine adhesions was significantly related to the number of previous curettage procedures (r=0.999, P<0.05).2. The main clinical manifestation of intrauterine adhesions was menstrual abnormalities(83%) and dysfunction of procreation (26.3%), the pre-operative menstrual pattern was significantly related to the severity of intrauterine adhesions (r=0.224, P<0.05).3. At the3-month follow-up, the rate of the post-operative recovery of uterine shape was66.4%,the recovery of menstrual pattern was82.3%, the pregnancy rate was52.2%. The severity of intrauterine adhesions, the post-operative menstrual pattern and the post-operative uterine shape was significanly positive correlation (P<0.05).4. Age, the pre-operative menstrual pattern postoperative was no significant related to conception (P>0.05). The severity of intrauterine adhesions, the post-operative menstrual pattern and the post-operative uterine shape was significantly related to conception (r=0.643, P<0.05).5.The expression of KGF in the endometrium of the mild, moderate and severe IUA patients were116.8±9.7,124.0±10.2,122.7±9.5,133.8±12.3. The expression of KGF in IUA patients were significantly higher than the control group (P<0.05).6. The expression of ER a in the endometrium of the mild, moderate and severe IUA patients were145.6±16.6,140.4±25.6, 134.7±15.3,161.5±16.5. The expression of ER α in IUA patients were significantly higher than the control group (P<0.05).7. The expression of KGF in the mild IUA patients were significantly higher than the moderate and severe IUA patients (P<0.05). The expression of ER a in the severe IUA patients were significantly higher than the mild IUA patients (P<0.05).Conclusion:1. The possible cause of IUA was previous curettage on gravid uterus (89.5%), The more the number of previous curettage procedures, the more severity of intrauterine adhesions.2. The pre-operative menstrual pattern can reflect the severity of intrauterine adhesions.3. The post-operative uterine shape was the biggest influence on conception.4. The expression of KGF and ER a in the IUA patients were significantly higher than the control group, which suggested that KGF and ER a participated in the endometrial injury repairing of patients with IUA.