The Expression Of P450 Aromatase In Endometrium Of Women With Adonomyosis, Endometrial Hyperplasia And Without Pathological Changes Of Endometrium And Its Clinical Significance

OBJECIVE: To investigate the funcion of P450 aromatase in eutopic endometrium of women with and without adonomyosis and in estrogen-dependent gynecologic lesions (endometrial hyperplasia and adonomyosis). To find out any relationship between presence of P450 aromatase and estrogen(ER) and progesteron(PR) receptors.METHODS: The examined samples were obtained from patients of JINAN RAILWAY MEDICINE HOSPITAL (2002-2004),There were four experimental groups:endometrial hyperplasia, adonomyosis and eutopic endometrium of women with and without endometriosis.P450arom,ER and PR were detected by using immunohistochemical methods with specific antibodies.The routine two-step immunnohistochemical technique was used to measure the expression of aromatase p450 and ER, PR in endometrium.RESULTS: l.P450aroma was expressed in eutopic and ectopic endometrium of adonomyosis , endometrial hyperplasia , but P450 aromatase was negativeexpressed in endometrium without pathological changes , The scores of immunohistochemical analysis were 27.6 ±705, 17.6 + 5.1 and 18.1 ± 12.6 respectively.The expression of P450 aromatase in ectopic endometrium was stronger than that of eutopic endometrium (P=0.000, P=0.009, P<0.05) . P450 aromatase was expressed in the smooth muscle tissues around ectopic endometrium also.2.There was no difference of expression of P450 aromatase between proliferative and secretory endometrium of adonomyosis (P>0.05) .3.Estrogen and progesteron receptors were detected in all examined tissues.Lower number of ER and PR was found in in ectopic endometrium of adonomyosis compared with eutopic endometrium ( Per=0.047, Per =0.023, Ppr=0.003, Ppr =0.002 , PO.05) . High number of ER was found in endometrial hyperplasia compared with the other endometriums (P=0.000, P=0.002, P=0.015, P<0.05) .There was not found any direct relationship between presence of P450 aromatase and both types of receptors( pearson correlation:-0.183; -0.176, P>0.05)c CONCLUSION: 1. Aromatase p450 is the key enzyme for biosynthesis of estrogen, which is an essential hormone for the establishment and development of the estrogen-dependent gynecologic diseases. pathological changes ofestrogen-dependent gynecologic lesions (endometrial hyperplasia and adonomyosis) is due to molecular aberrations and abnormally high circulating estrogen levels.2.There is no detectable aromatase enzyme activity in normal endometrium.3. There is not found any direct relationship between presence of P450 aromatase and estrogen(ER) and progesteron(PR) receptors,The expression of P450 aromatase is not associated with the menstrual cycle.lt may be regulated by the way of self (or side) -secretion.4. P450aroma was expressed in eutopic and ectopic endometrium of adonomyosis and endometrial hyperplasia, So it is not possible to use detection ofP450 aromatase as a diagnostic test for pelvic endometriosis, but it may be regarded as a method of screening the estrogen-dependent gynecologic diseases.