Expression And Significance Of Carbonic Anhydrase-9Protein In Adenomyosis

Objective:This study is aimed to evaluate the expression level of carbonic anhydrase-9(CA-9) protein in adenomyosis foci and in normal uterine smooth muscle, examine whether morphologically hypoxic change of ultra microstructure exist in the adenomyosis foci, and to analyse the correlation between hypoxia and dysmenorrhea of adenomyosis, hoping to elucidate the role of hypoxia micro-environment and CA-9protein in the pathogenesis of adenomyosis.Methods:28samples of adenomyosis foci and29samples of normal uterine smooth muscle were evaluated by immune-histo-chemical staining for the expression of CA-9protein, and the expression level of CA-9protein between patients with and without dysmenorrhea were compared;3adenomyosis foci sample and1normal myometrium sample were examined by transmission electron microscope to detect whether the hypoxia change of ultra microstructure such as mitochondrial swelling and bleb-like change exists in the adenomyosis foci.Results:1. as shown by immunohistochemical staining, The average expression level of CA-9protein in adenomyosis foci is (10.60±2.84), which is obviously elevated compared with the expression level (1.35±0.52) in normal uterus smooth muscle; statistically significant difference exists between the two groups (P<0.05).2. As examined by transmission electron microscope, the normal smooth muscle of uterus presents with normal cell morphology, without tissue edema, and normal mitochondrial shape, without swelling and bleb-like change, and few sarcoplasmic reticulum; the adenomyosis foci shows hypoxia change of ultra microstructure:tissue necrosis and edema with abnormal atrophied cell and increased electron density in cell plasman mitochondrial swelling and bleb-like change as well as many enlarged sarcoplasmic reticulum.3. The expression level of CA-9protein in adenomyosis patients is correlated with the clinical symptom of dysmenorrhea; the expression level of CA-9in patients with dsymenorrhea is (11.78±1.94), which is elevated compared with the expression level (9.42±1.87) in the patients without dysmenorrhea; statistically significant difference exists between the two groups (P<0.05).Conclusions:1. Expression of CA-9protein is significantly elevated in the adenomyosis foci compared to the normal myometrium, and hypoxia change of ultra microstructure exist in adenomyosis foci, indicating the possible role of hypoxia microenvironment in the pathogenesis of adenomyosis.2. The expression level of CA-9protein in adenomyosis foci is correlated with the clinical symptom of dysmenorrhea, with higher expression level in patients with dysmenorrhea than without dysmenorrhea, indicating hypoxia microenvironment may be one of the factors affecting dysmenorrhea.