Expression Of Decorin, Collagen Ⅰ And Ⅲ In Cardinal Ligament Tissue And Its Relationship With Pelvic Floor Dysfunction

Objective: Disease of female pelvic floor dysfunction (PFD) mainly includes pelvic organ prolapsed (POP) and stress urinary incontinence (SUI).With the ageing population and the more require about the quality of life, the incidence rate and the rate of seeking treatment increases gradually year by year. The disease makes serious downside influences about people's life style, society life, and psychology and sex life. Studies have reported, the content, structure, function and the abnormal ratio of each type of collagen have close relationship with the disease of PFD. Now, the etiology and pathogenesis are not very clear. By observing the relativity of expression of decorin, typeⅠcollagen and typeⅢcollagen in cardinal ligament of uterus tissues, we try to detect biochemical changes in cardinal ligament tissue of people with pelvic floor dysfunction, to analysis the relationship of the alteration in collagen content, decorin expression and PFD, and find the new way to remedy the disease of PFD.Methods:1 Biopsy specimens of cardinal ligament tissues were obtained from the women who visited the department of gynecology and obstetrics of people hospital of Hebei Province from November 2009 to September 2010. Forty women participated in the study. They were divided into four groups as follows: ten premenopausal patients with PFD, ten premenopausal patients without PFD, ten postmenopausal patients with PFD, ten postmenopausal patients without PFD. The expression of decorin, the content of typeⅠcollagen and typeⅢcollagen were detected by immunohistochemical technique and computer image analysis system.2 Analyze the data with SPSS13.0. Results:1 Light microscope histological features of cardinal ligament (HE stain) In the experiment, we observed that the main component of the cardinal ligament tissue was smooth muscle cell, fibroblast and collagen.In the cardinal ligament of both premenopausal and postmenopausal patients with PFD, we saw that the density of collagen fibers was low, the arrangement was sparse, and focal. The smooth muscle looked more cushing. The arrangement was also sparse. The interstice between bundles of smooth muscle became bigger. We can see the degeneration of the cardinal ligament tissues, such as endochylema hydrosarca, vacuolar degeneration and amyloidosis.In the cardinal ligament of both premenopausal and postmenopausal patients without PFD, we saw that the arrangement of the collagen fibers was fasciculate and orderly. The smooth muscle was thick, and in regular arrangement.2 The expression of decorin in cardinal ligament tissuesThe expression of decorin located in the extracellular matrix. It's distribution was diffuse or focal.In the premenopausal patients: The expression was177.55±10.04 in the study group, while it was 107.51±19.67 in control group. There was significant difference between two groups (P <0.05)In the postmenopausal patients: The expression was168.51±7.66 in the study group, while it was 91.02±8.44 in control group. There was significant difference between two groups (P <0.05).3 The expression of typeⅠcollagen in cardinal ligament tissuesThe expression of typeⅠcollagen located in the extracellular matrix, and some fibroblast cytoplasm. It's distribution was diffuse or focal.In the premenopausal patients: the expression of typeⅠcollagen in the study group(94.41±14.67) was lower than the control group (180.62±8.34).There was significant difference between two groups (P<0.05).In the postmenopausal patients: the expression of typeⅠcollagen in the study group(94.59±7.88) was lower than the control group (171.94±14.15).There was significant difference between two groups.(P <0.05).4 The expression of typeⅢcollagen in cardinal ligament tissuesMajority of typeⅢcollagen were appeared in the extracellular matrix majority, and less in fibroblast cytoplasm. It's distribution was diffuse or focal.In the premenopausal patients: the expression of typeⅢcollagen in the study group(80.15±6.11) was lower than the control group(150.79±18.27)Both of these consequence were significantly different between control and study groups(P<0.05).In the postmenopausal patients: the expression of typeⅢcollagen in the study group(82.81±7.76) was lower than the control group(147.11±17.82). Both of these consequences were significantly different between control and study groups (P<0.05).5 The correlation of typeⅠcollagen ,typeⅢcollagen, and decorin.In the premenopausal patients: The expression of typeⅠcollagen in study group is negative correlation to the expression of decorin (r=-0.845,p<0.05);The expression of typeⅢcollagen in study group is negative correlation to the expression of decorin (r=-0.845,p<0.05).In the postmenopausal patients: The expression of typeⅠcollagen in study group is negative correlation to the expression of decorin (r=-0.935,p<0.05);The expression of typeⅢcollagen in study group is negative correlation to the expression of decorin (r=-0.921,p<0.05).Conclusions:1 In the study, we found that both premenopausal and postmenopausal women with PFD had a significantly low typeⅠcollagen and typeⅢcollagen in cardinal ligament tissues, suggesting that changes in collagen metabolism was probably cause the occurrence of PFD.2 We found that both premenopausal and postmenopausal women with PFD had a significantly high expression of decorin in cardinal ligament tissues; it may play a important role in the occurrence of PFD.3 In premenopausal and postmenopausal women with PFD ,We found a strong correlation between the content of typeⅠcollagen ,typeⅢcollagen and the expression of decorin in cardinal ligament tissues, suggesting that the decrease of collagen was altered by the increase of decorin , suggesting that the increase of decorin may take part in the occurrence of pelvic floor dysfunction.