The Expression Of NF-κB, PR, ERα And ERβ In The Proliferative Endometrial Polyps And Its Role In It

Objective: Endometrial polyps (EP), is a common gynecological diseases. At present the incidence of endometrium polyposis advances unceasingly, the prevalence rate approximately is 24~25%. Because the pathogenesis is not clear, it is difficult to cure but easy to recur, or become malignant. Is generally believed that the disease is influenced by genetic factors,immune response and endocrine disorders. In brief, endometrium polyps′occurrence has deep relationship with the inflammation response and steroid hormone level in vivo and female progestogen acceptor level. In recent years, it is found that nuclear factor-κB(NF-κB) system mainly involved in organism defense reaction, the organization damage , the stress, the cell differentiation and perishes weakly as well as the tumor growth. As a information transmission, NF-κB plays an important role in vivo inflammation circuit, which aslo express the masculine gender in various tumors, including many kinds of polyps. With the constant deepening of research, it is found that there is crosstalk exists between NF-κB system and estrogen and progesterone and its receptor signaling system. In study with reproductive Medicine and stress, people found Steroid hormone can inhibit NF-κB by inhibiting its subtype or Hinder its inhibitor degradation. Endometrium was in a special environment where there are inflammation and steroid hormone interacting with eachother. Furthermore, the incidence of endometrial polyps closely relates with them. We have detected the expression of NF-κB, PR, ERαand ERβin proliferative phase endometrium polyp, tissue besides endometrial Polyp and normal proliferative phase endometrium and studied the correlation among them. My research focused on studying the pathogenesis of endometrial polyps. So that we can learn more about the pathogenesis of endometrial polyps and provide theoretical support to its treatment. There was little reports about NF-κB in endometrial Polyps by now.Methods: 30 case of endometrial polyps were obtained from the patients who had a surgery treatment by hysteroscopy (transcervical resection of endometrialpolyps, TCRP) from January to December in 2008 in the second hospital of HeBei province.All the polyps must be single or partial aggregation. Collecting the smooth tissue which were 0.5cm far from the polyps at least. 30 case of normal endometria were obtained from the patients who have the operation by hysteroscopy for the reason of reproductive tract malformations. Excluded thoes had endocrine or the inflammation factor influenced endometria such as Dysfunctional Uterine Bleeding, endometritis, infertility and so on. All the endometrial polyps and the Proliferative phase endometrium were confirmed by Pathological examination. Immunohistochemical method was used to detect the expressions of NF-κB, PR, ER and ERβin 30 endometrial polyps tissue, lateral endometria tissue and normal endometria tissue. It was evaluated by way of semiquantitative analysis (Chi-square test) and sperman's correlatin for rank. The statistical software SPSS 13.0 was used to analyze the data.Results:(1) In HE stain of the 30 case tissue besides endometrial polyp, 16 case of which are diagnosised proliferative phase of endometrium, 7 case of which are diagnosised as endometrial polyp, 7 case of which are diagnosised Simplicity proliferative of endometrium. (2) Immunohistochemical staining for NF-κBp6 protein was located at the cytoplasm. The expression of NF-κBp65 protein in trophocyte showed significant higher in endometrial polyp stissue (positive rate=90.0%) and tissue besides Polyp (positive rate=83.3%) than in control group (positive rate=56.7%):χ2 =6.903,5.079, P<0.05, The expression in endometrial polyps and tissue besides polyp aren't statistically significant (P>0.05). (3) Immunohistochemical staining for PR protein was located at the nucleus. The expression of PR protein in nucleus showed significant higher in control group (positive rate=80.0%) and tissue besides Polyp (positive rate=83.3%) than in endometrial polyp stissue (positive rate=50.0%). (χ2=5.934,7.500, P<0.05) The expression in control group and tissue besides polyp aren't statistically significant. (P>0.05) (4) Immunohistochemical staining for ERαprotein was located at the nucleus. The expression of ERαprotein in nucleus of endometrial polyp stissue (positive rate=80.0%), tissue besides Polyp (positive rate=66.7%) and control group (positive rate=60.0%) aren't statistically significant. (P>0.05) The positive expression in medium intensity Polyp group is highter than control group. (P>0.05) (5) Immunohistochemical staining for ERβprotein was located at the cytoplasm. The expression of ERβprotein in cytoplasm of endometrial Polyp stissue (positive rate=66.7%), tissue besides Polyp (positive rate=56.7%) and control group (positive rate=70.0%) aren't statistically significant. (P>0.05) (6) Throught spearman anlysis, the NF-κBp65, ERαand ERβin the endometrial Polyp stissue wasn`t correlation significantly. But the expression of NF-κBp65 and PR was negatively correlated to PR significantly. ( Correlation coefficient=-0.735, P<0.05)Conclusions: (1) The low expression of PR cuold lose the inhibition to NF-κB, which is the main reason that lead to endometrial polyps. (2) NF-κB may have relationship with endometrial polyps recurrent or multiple endometrium polyps. (3) Choose progesterone class medicine as a supplement and diminish inflammation in proliferative phase to treat proliferative phase endometrial polyps, could be Effective.