Expression And Significance Of Bcl-2, ER, PR And CD138 In Endometrial Hyperplasia

ObjectiveTo study the difference of expression of Bcl-2,ER,PR and CD138 in different forms of endometrial hyperplasia.To explore the significance of the expression of the above protein molecules in the occurrence and development of endometrial proliferative lesions.Methods107 cases of hysteroscopic surgery were reviewed.The histological phase of endometrium was confirmed according to the menstrual cycle and endometrial pathology.The study group included 78 cases of endometrial hyperplasia,including 43 cases of simple hyperplasia,21 cases of complex hyperplasia and 14 cases of atypical hyperplasia.The control group included29 cases,including 17 cases in proliferative phase and 12 cases in secretory phase.The expression of Bcl-2,ER,PR and CD138 in different types of endometrium was detected by Envision system.And further analyze the significance of changes in the expression of protein molecules and receptors.Results1.The basic data of patients with endometrial hyperplasia(N = 78)were compared with those without endometrial hyperplasia(N = 29),there were significant differences in BMI(P = 0.003),abnormal uterine bleeding(P=0.001),Endometritis syndrome(P= 0.015)and infertility(P = 0.049)between the two groups(P <0.05).There was no significant difference in age(P=0.696),hypertension(P = 0.280),diabetes mellitus(P = 0.287)and basal sex hormone level(P = 0.596)(P > 0.05).There are a lot of confounding factors related to infertility,such as the patient’s willingness,social factors,and so on.Conclusion from the percentage of patients with proliferative endometrium infertile slightly higher chances.2.The expression of Bcl-2,ER and PR in proliferative endometrium was higher than that in secretory endometrium.The expression level of endometrial receptor in secretory phase was significantly lower than that in proliferative phase,and the descending range was Bcl-2,ER and PR in turn.The difference was statistically significant(P< 0.05).3.The expression of Bcl-2,ER and PR in the endometrium of proliferative dysplasia was higher than that in the endometrium of proliferative dysplasia.The expression levels of Bcl-2,ER and PR in different pathological types of endometrial hyperplasia were simple hyperplasia & GT;complex hyperplasia >atypical hyperplasia(P<0.05),the expression of Bcl-2 was positively correlated with the expression of ER and PR.The expression of Bcl-2,ER and PR was positively correlated with the degree of endometrial differentiation and the prognosis of endometrial hyperplasia.The higher the expression of Bcl-2,ER and PR was,the better the prognosis was.The difference was statistically significant(P<0.05).4.In the control group(N = 29),CD138(dot+)accounted for 3%(1/29).In the study group(N = 78),CD138 was positive in 17 cases(21.7%).Among them,there were 2 cases of simple hyperplasia,2 cases of complex hyperplasia and 13 cases of atypical hyperplasia,the percentages were 2.5%,2.5% and 16.6% respectively.All CD138 positive cases were dot-positive,which had statistical significance in the percentage of cases(P<0.05).Conclusions1.Changes in endometrial proliferative diseases are more likely to occur in obese women with high BMI,who have a higher chance of developing abnormal uterine bleeding,endometritis,and infertility.There was no significant difference in age factors between the non proliferative endometrial group and the proliferative endometrial group,while the proliferative lesion group showed a younger trend.In addition,this study observed that the occurrence of endometrial proliferative diseases was not significantly related to hypertension and diabetes,which needs to be further verified by expanding the sample size.2.The results of this study showed that the expression level of Bcl-2 in proliferative endometrium was generally higher than that in normal proliferative endometrium,indicating that the abnormal gene expression of endometrial glandular cells and the reduction of apoptosis may exist in proliferative lesions.The expression level of Bcl-2 in endometrial tissue of cases of atypical hyperplasia is lower than that of simple hyperplasia and complex hyperplasia,indicating that there may be other mechanisms involved in the progression of endometrial hyperplasia to atypical hyperplasia or even cancer transformation,and further exploration and research are needed.3.The expression level of ER and PR in endometrial hyperplasia was higher than that in normal endometrial proliferation and secretory phase.4.The expression level of BCL-2,ER and PR was positively correlated with the degree of endometrial differentiation and the prognosis of endometrial hyperplasia.The higher the expression level of BCL-2,ER and PR was,the lighter the degree of endometrial hyperplasia was,the better the prognosis.Combined detection of BCL-2,ER and PR may be more valuable in the diagnosis and prognosis of endometrial hyperplasia.5.The positive expression of CD138 was correlated with atypical hyperplasia in endometrial hyperplasia,suggesting that chronic Endometritis may be involved in the development of endometrial hyperplasia.