Detection Of Apoptosis Regulation Protein Survivin,PCNA And Cell Apoptosis In Endometriosis And Its Clinical Significance

Background and ObjectiveEndometriosis, a common disease among women of reproductive age, A benign disease with malignant activity . Classic symptoms of endometriosis are dyspareunia, chronic pelvic pain, dysmenorrhea, and infertility. Affected women often have a poor quality of life.The incidence is ascend.Bacause the aetiology of endometriosis is unknown , the effect of therapy are limited ,it is difficult to be cured,and high rate of recrudescence . so we give more attention to the research about endometriosis. There are more and more research indicated Spontaneous apoptosis is decreased and proliferative is increased in women with endometriosis, This may indicate increased viability of endometrial cells and facilitating their ectopic survival and implantation. Survivin is a novel inhibitor of apoptosis and is expressed during fetal development and in cancer tissues, but its expression has not been reported in normal adult tissues or benign diseases.PCNA is a kind of acid nuclear protein. It is indispensable for cell DNA compound, expression in the course of cell proliferative,increased in the period of G1, higher in the period of S decreased in the period of G2/m,and lower in the period of M. so can be an index for cell proliferative.There has been no report on the biological significance of survivin in endometriosis.We investigated survivin protein expression in endometriosis, and correlated them with apoptosis of endometriotic tissues.and investigated the conditionof proliferative by PCNA protein expression . This study focused on the alterations in regulation of apoptosis and proliferative in eutopic and ectopic endometrium from women with endometriosis. To calarify the mechanism of happen development invade and plant in endometriosis.the role of apoptosis and proliferative in the treatment of endometriosis is reviewed to link the basic research findings into clinical applications. MethodsExpression of survivin protein ,proliferating cell nuclear antigen labeling index (PI) were detected immunohistochemically and Spontaneous apoptosis was evaluated using TdT-mediated dUTP-biotin nick end-labelling (TUNEL) assay. A P values less than 0.05 indicated statistical significance. Results1) survivin protein expression that was strongest in glandular epithelial cells during the late secretory phase, In the proliferative phase, glandular epithelial cells were not stained for survivin( PO.05).2) In the proliferative phase ,survivin expression in eutopic endometrium from women with endometriosis were lower compared with secretory phase,but were higher than secretory phase in control( PO.05).3) survivin expression in ectopic endometrium were higher compared with secretory phase in eutopic endometrium( PO.05), and no cyclic change was demonstrated.4) the PI was higher in eutopic endometrium in endometriosis than in controls,but was lower than in ectopic endometrium( PO.05).5) the apoptosis index in glandular epithelium was lower in eutopic endometrium in endometriosis than in controls, but was higher than in ectopic endometrium( PO.05).Conclusion1) Eutopic endometrium from women with endometriosis reportedly the activity of proliferation and apoptosis differences compared with normal endometrium of women without endometriosis. The differences could contribute to the survival of regurgitating endometrial cells into the peritoneal cavity and the development ofendometriosis. Those who have the up-regulation of survivin expression in eutopic endometrium ,have the possibility to be EMs.Filtrated these kind of endometrium by D&C ,may be a new way to forecast and diagnose EMs.2) The up-regulation of survivin expression in ectopic endometrium,indicated that survivin may play importent role in the development of EMs.3) the activity change of proliferation might lead to the growth and survival of ectopic endometrial tissue and development of endometriosis.Restrain proliferation in ectopic endometrium,shorten cell period,may advantaged to treatment for EMs.4) Apoptosis may play an important role in the development of the disease. Manipulation of cell death processes could be used to treat endometriosis. Advances in molecular biology and genetics will give a new way that help us to understand these issues and may yield prevention and treatment modalities for endometriosis in the near future.