Expression Level Of NF-κB/p65, P16 And Ki67 In Endometrial Hyperplasia With RU486 Treatment

ObjectivesThe clinical application of mifepristone(RU486) has been expanding since it was first developed by the French company Roussel-Uclaf as a kind of progestone antagonist in the 20th century. The short effect of RU486 on endometrial hyperplasia is sure, however, its mechanisms have not been fully and clearly explained. We gained the endometrial tissue of women with endometrial hyperplasia before and after treatment by RU486, and then to detect the expression of NF-κB/p65, p16 and ki67 protein in endometrial tissue, as well as observe the HE staining, to explore the followingquestions:1. observe the changes of endometrial gland and stroma with HE staining by optical microscope.2. clarify the effect of NF-κB/p65 in the pathogenesis of endometrial hyperplasia and in the process of RU486 treatment on endometrial hyperplasia.3. clarify the role of p16 in the process of RU486 treatment on endometrial hyperplasia.4. clarify whether the process of RU486 treatment on endometrial hyperplasia affected the activity of endometrial cell proliferation by ki67 expression.MethodsThirty-seven women with irregular bleeding from vagina was diagnosed as endometrial hyperplasia patients, taking RU486 straint treatment according to 10 mg/d for 3 months, and then the endometrial tissue of before and after treatment was obtained by curettage as pre- and post-treatment groups. Observe the changes of endometrial gland and stroma of HE staining by optical microscope and try to divide the gland into large gland and small gland (in average diameter 200μm as a benchmark),and divided the stroma into dense area and rarefied area(in stromal cell density 1/μm2 as a benchmark),as well as, detect the expression of NF-κB/p65, p16 and ki67 protein in endometrial tissue with Envision immunohistochemical staining. Using SPSS16.0 statistical software for data processing, test taking two sides a= 0.05.Results1. The proportion of expansion large gland of pre-treatment group is higher than that of post-treatment group, besides, gland of pre-treatment group has pseudostratified epithelial layer, thin or fat round nucleus, and higher nuclear/ cytoplasmic ratio. Gland of post-treatment group has single epithelial layer, dwarf cubic columnar nucleus, and lower nuclear/cytoplasmic ratio what compared with that pre-treatment is statistically significant (P＜0.05) and gland is smaller than that of pre-treatment(P＜0.05).2. stromal density has no significant change between pre-teatment and post-treatment(P＞0.05).3. NF-KB/p65 protein positive signal in post- treatment gland is stronger than that in pre-treatment (P＜0.05), while no difference in the expression of stroma (P＞0.05).4. p16 protein positive signal has no significant difference between the two groups (P＞0.05), but the most positive large gland were significantly more than other large gland (P＜0.01); the positive signal of pre-treatment rarefied stroma area is stronger than that of pre-treatment dense stroma area (P＜0.05).5. post- treatment compared with pre-treatment significantly decreased ki67 expression (P＜0.05), and ki67 positive signal of dense stroma area is stronger in two groups(P＜0.05).Conclusions1. RU486 effectively reducing the gland s tension, changing the size of the gland and changing the nuclear/cytoplasmic ratio of glandular epithelial cells, indicating maybe RU486 inhibiting the gland s proliferation through non-competitive anti-estrogen effect.2. RU486 treatment on endometrial hyperplasia (especially to gland) may be related to NF-κB/p65-mediated signaling pathways.3. RU486 can be through non-pl6-related mechanisms, reducing endometrial cell proliferation activity.