| Objective: To investigate the expression of the HOXA11 and estrogen receptor alpha and beta, the pathologic changes to the collagen fibers and elastic fibers in the part of uterosacral ligament of patients with pelvic organs prolapse(POP), in order to infer the pathogenesy of it. Uterosacral ligament is one of the most important utero surport tissues, which changes of appearance and component can lead to POP. HOXA11 is one of the special congenital gene of growth, and ER-α,ER-β,collagen fiber and elastic fiber all are related to the changes of utero ligament's tenacity.Methods: uterosacral ligaments tissues were obtained from near cervix, about 0.5～1.0cm long, full aperture. This tissues were obtained from 16 women who visited the department of gynecology of the second hospital of Hebei medical university during May 2008 to November 2008. The study and control group included 8 patients individually, all of them are postmenopausal women except of 1 case. There was 1 case under high abdominal pressure long-term (chronic cough and constipation) in study group. HOXA11,ER-αand ER-βwere detected by immunohistochemistry (PV method) and the expression was scored based on H-score. Collagen fibers and elastic fibers were stained by ponceau acid fuchsin and resorcinum methods individually, and the expression intensity were evaluated based on the area of collagen fiber and elastic fiber.Results:1 Compared to the control group, the degeneration of uterosacral ligament were found in POP, such as endochylema hydrosarca, vacuolar degeneration and amyloid degeneration.2 specific stain:2.1 The observation of collagen fibers were green, while smooth muscle cells and red blood cells were red. Colour of collagen fibers in POP group was quite weaker than that in control group.2.2 Elastic fibers were blue-black. They appeared hypocurvature, hypodensity, anomalism, disrupt and in a mess in POP group, while they were continuous and uniform distribution localized in control group.3 HOXA11 was expressed mostly in cell nucleus and less in endochylema.The protein intensity was 3.58±0.14 in the postmenopause control group, while it was 3.19±0.35 in study group.There was significant difference between two groups (P<0.05).4 Estrogen receptor subtypes:4.1 ER-αwere markedable observed in nucleus, its magnitude was noticeably lower in POP group (2.89±0.33)than that in control group(3.11±0.28), P<0.05. 4.2 Majority of ER-βwere appeard in endochylema,which magnitude was under the same situation: 3.26±0.26 in POP group higher than 2.92±0.38 in control group. Both of these consequence were significantly different between control and study groups, P<0.05.5 HOXA11 is positive correlation to ER-α(r=0.713, P<0.01) and the same to ER-β(r=0.5,P<0.05).Conclusions:1 The uterosacral ligament of postmenopausal female with POP was obviously degenerated.2 Collagen fibers of uterosacral ligaments were light-colored and elastic fibers were broken.3 The decrease of HOXA11 expression was related to postmenopausal POP. This depress maybe resulted in congenital development discrepancy and inability of recovery after being hurt.4 The reduce of ER-α,ER-βmagnitude may significantly related to postmenopausal POP. The insufficient could effect capability of antitession.5 There are direct correlation between HOXA11 and ER-α,ER-β.We suppose that there would be some relatives between them by some way.
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