Expression Of Epidermal Growth Factor Receptor EGFR And Ki-67 In Adenomyosis Tissues And Its Clinical Significance

ObjectiveAdenomyosis is a condition in which endometrial tissue, which normally lines the uterus, is present within and grows into the muscular walls of the uterus. The cause of adenomyosis isn't known yet. This study is to explore EGFR and Ki-67 expressions in adenomyosis and their relationship with the clinical manifestations, to investigate correlation between adenomyosis and EGFR and Ki-67 expressions. we may investigate the pathogenesis of adenomyosis and the possible factors for the cause of adenomyosis, and further provide theory and application support for future research and treatment of adenomyosis.Data collection and analysisIn this study data we collected inpatients data from January 2006 to September 2009 at the First Affiliated Hospital of Shanxi Medical University. We selected adenomyosis, uterine adenomyoma cases and CINIII cases. All cases were confirmed by surgery and pathology. We have control group and study group. For both groups there are two phases, proliferative phase and secretory phase,Control Group:24 cases,age between 34—50, average age is 43.54±6.69. CINIII cases, non-menstrual changes, no requirement of procreation but IUD insertion, no use of any medication.Study Group:70 cases,age between 33—53, average age is 45.99±5.03. Adenomyoma adenomyosis group without any treatment. We recorded the patients'dysmenorrhea age and degree and menstrual information.Drawn Parts in Each Group:Control Group:normal endometrium, sub-proliferative phase, secretory phase. Study Group:eutopic endometrium, ectopic endometrium, sub-proliferative phase, secretor phase.Detection Methods:Tissue microarray technology and immunohistochemistry.Detection Targets:EGFR, Ki-67Results1. Positive Ki-67 Expression and Adenomyosis:Adenomyosis tissue Ki-67 positive expression rate is 64.3%; compared with normal endometrium, uterine adenomyosis positive expression was significantly increased (P< 0.05) (Table 1.1). There is no significant Ki-67 positive expression difference in two adenomyosis groups (Table1.2) and the reason may be that Ki-67 has similar effects in the pathogenesis of the two adenomyosis diseases. Further studies on this topic are needed. In this experiment the two adenomyosis groups will be classified as a unified experimental group. In the proliferative phase positive expression rate is 63.2%; in the secretory phase expression rate is 65.6%. From the perspective of epithelial cell proliferation, there is no significant difference (P> 0.05) between positive expression rate during proliferative phase and expression rate during secretory phase (Table 1.3), indicating that glandular epithelial cells of adenomyosis do not have a cyclical change and hormonal effect change. Eutopic endometrium and normal endometrial cells are similar in proliferation (Table 1.4); in the secretory phase, ectopic endometrial glandular Ki-67 expression are higher than the eutopic endometrium and the control group (Table 1.5); ectopic Ki-67 expression in endometrium during the menstrual cycle changes is significantly different from eutopic endometrium and normal endometrium group (Table 1.4-Table 1.5). High Ki-67 expression illustrated active cell proliferation in the adenomyosis gland epithelial cells. In part of adenomyosis tissue sections, we see that yellow brown color in vascular cells, showing that when there is abnormal proliferation of glandular epithelial cells, the vascular proliferation is also very active. Positive expression of Ki-67 is unrelated to patient's age, degree of dysmenorrhea, uterus size and menstrual amount changes (P> 0.05) (Table 1.6).2, Positive EGFR Expression and Adenomyosis:EGFR positive expression is mainly glandular epithelial cells coloring which is mainly in the cell membrane and cytoplasmic with only a small amount of shading in stroma. Ppositive EGFR expression rate is 48.6%; compared with normal endometrium, uterine adenomyosis positive expression is significantly increased (P <0.05) (Table 2.1). Difference between the two adenomyosis groups in positive expression rate of EGFR is not statistically significant (Table2.2) and the reason might be EGFR has similar effects in the pathogenesis of the two adenomyosis diseases. This topic needs further study. In this experiment the two adenomyosis groups will be classified as a unified experimental group to study. In the proliferative phase positive expression rate is 65.7%; in the secretory phase expression rate is 31.4%.The difference between proliferative phase rate of positive expression of EGFR is statistically different compared with the secretory phase rate (P<0.05) (Table 2.3), indicating that EGFR and the menstrual cycle have a certain relationship, and EGFR is also associated with sex hormone changes. Further study in this topic is ongoing. Positive expression of EGFR in ectopic endometrial cells is significantly higher than eutopic endometrium and normal endometrium group (P<0.05) (Table2.4). EGFR expression in eutopic endometrium increased significantly compared with normal endometrium (P<0.05) (Table2.4). In secretory phase, eutopic endometrium and normal endometrium has lower EGFR positive expression than in proliferative phase, but data does not show significant difference (P> 0.05) (Table 2.5). EGFR is independent with the adenomyosis age, degree of dysmenorrhea, uterus size and menstrual amount change (P> 0.05) (Table2.6).3. Ki-67 and EGFR Correlation Analysis:In this experiment, both Ki-67 and EGFR expressions in adenomyosis patients have high positive rate, there is significant difference (P< 0.05) (Table3.0), which shows certain synergy in the occurrence and development of adenomyosis, but due to current available data we can not derive conclusion on their correlation. Literature shows that there are weak correlation between Ki-67 and EGFR. This topic is under investigation.