Study On The Expression Of E-Cadherin And Inos In Patients With Adenomyosis Of The Uterus

Background and Objectives:Adenomyosis is a benign disease and caused by the invasion of endometria into myometrium.It's a common gynecopathy and it's clinic feature is enlarged uterus,menorrhagia and dysmenorrhea.The exact pathological activity of adenomyosis isn't known completely by us,but held generally that adenomyosis is caused by the direct invasion of endometrium into myometrium.Up to now the causing and pathegenesis of adenomyosis isn't known exactly.Current research suggests that dysimmunity and angiogenesis may play critical roles in the pathegenesis of endometriosis.E-cadherin is one of the most important mediums that adjust the adhesion between cells and play an important role in maintaining the normal structure of any tissue.Other adhesin practically have no effect while E-cadherin exacts.So E-cadherin may play an important role in the pathegenesis of the endometria's invasion into myometrium.Beside that ,it was suggests that developed angiogenesis provide favourable conditions for the planting and growing of endometria inmyometrium.NO(nitric oxide) can induce the proliferation of endothelium to adjust the angiogensis and blood flow.It may takes important in the planting and growing of endometrium in myometrium.In the present study immunohistochemical staining was used to defect the expression of E-cadherin and iNOS(inducible nitric oxide synthase) in defferent part of uterus and give guideline for the study of pathophysiology of andadnomyosis.Materials and Methods:The study included 38 patients with histologically proven adenomyosis and 31 patients with asymptomatic leiomyoma of the uterus. Immunohistochemical staining was used to detect E-cadherin and iNOS expression in different part of uterus. The expreesion degree is expressed as Histology score ( H-score) and marked as mean±standard deviation(X±s). The data is analysed by t-test. Result:1. The results about E-cadherin:The E-cadherin H-score of glandular cells in the endometrium of adenomyosis uterus[proliferative phase(9.6 ± 1.4),secretory phase(11.6±1.6)] was much higher than that of leiomyoma uterus [proliferative phase(8.3±1.6),secretory phase(10.1 ±1.5 )](p<0.05)and increased in the secretory phase(p<0.05). Compared with eutopic endometrium ,the E-cadherin H-score in ectopic endometrium[proliferative phase(12.2±1.7 ),secretory phase(12.2±1.7 )] increased significantly(p<0.05),but showed no cyclic change(p>0.05).The myometrium and interstitial gland has no positive expression in any groups.2. The results about iNOS :The iNOS H-score of glandular cells in the endometrium of adenomyosis uterus [proliferative phase(4.8± 1.9),secretory phase (4.5± 1.4)]was not different from [proliferative phase(4.1 ± 1.3),secretory phase(4.3 ± 1.3)](p>0.05)and was not increased in the secretory phase too(p>0.05). Compared with eutopic endometrium ,the iNOS H-score in ectopic endometrium [proliferative phase(9.5 ± 1.3),secretory phase(8.7 ± 1.3)] increased significantly(p<0.05),but showed no cyclic change(p>0.05). The iNOS H-score (8.6±1.3)of vessel smooth muscle cell in adenomyosis uterus was much higher than that of leiomyoma uterus(3.5 ±1.4). The myometrium and interstitial gland has no positive expression in any groups. Conclusions:1 .The eutopic endometrium and ectopic endometrium of adenomyosis has much higher H-score and it suggested that E-cadherin play an important role in thedevelopment of adenomyosis.2.The iNOS H-score in the ectopic endometrium of adenomyosis is much higher than that of eutopic indometrium and it suggested that the angiogenesis activity of ectopic endometrium was markedly increased. The higher iNOS H-score of vessel smooth muscle cell in adenomyosis uterus show that hemangiectasis was exist.