Bcl-2 Expression Of Bax And P21 <sup> Of Waf1 </ Sup> In The Endometrium In Adenomyosis Patients And Its Correlation Study

Purpose:Discussing the expression and correlation of Bcl-2, Bax and p21WAF1 factor in endometrial of the patients who contract adenomyosis to further study the reasons of occurrence and development of adenomyosis.Methods: Detecting the expression of Bcl-2, Bax and p21WAF1 in adenomyosis lesions (including endometriotic and eutopic) of the 60 adenomyosis patients (experimental group) what were formed by 30 cases in proliferative phase and 30 cases in secretory phase by immunohistochemistry SP method. Through pathologically confirming I selected 30 cases of normal endometrial that belonged to the patients (control group) who received hysterectomy surgery because of uterine fibroids. Then I controlled these 15 cases in proliferative phase and 15 cases in secretory phase.Results:1. Bcl-2 and Bax mainly expressed in the cytoplasm of glandular epithelial cells in the experimental group and control group. Positive cells showed diffuse distribution. P21WAF1 expressed in the nucleus of glandular epithelial cells in the experimental group and control group.2. Bcl-2 expressed cyclically in the endometrial of control group. It was more active in proliferative phase than secretory phase which had significant differences (P <0.05). Bcl-2 expressed cyclically in the eutopic of experimental group. It was also more active in proliferative phase than secretory phase which had significant differences (P <0.05). Bcl-2 did not express cyclically in the endometriotic of experimental group. It expressed strongly in both proliferative phase than secretory phase which did not have significance in Statistics(P>0.05). Compare to the expression of eutopic in the control group and experimental group in the same period, the results both showed significant differences (P <0.05). Compare to the expression of endometriotic in the control group and experimental group in the same period, the results both showed significant differences (P <0.05). Compare to the expression of eutopic and endometriotic in the experimental group in the same period, the results did not have significance in Statistics(P>0.05).3. Bax expressed cyclically in the endometrial of control group. It was more active in secretory phase than proliferative phase which had significant differences (P <0.05). Bax expressed cyclically in the eutopic of experimental group. It was also more active in secretory phase than proliferative phase which had significant differences (P <0.05). Bax did not express cyclically in the endometriotic of experimental group. The comparison did not have significance in Statistics(P>0.05). Compare to the expression of eutopic in the control group and experimental group, the results did not have significance in Statistics (P>0.05)in proliferative phase but showed significant differences (P <0.05) in secretory phase. Compare to the expression of endometriotic in the control group and experimental group, the results did not have significance in Statistics (P>0.05)in proliferative phase but showed significant differences (P <0.05) in secretory phase. Compare to the expression of eutopic and endometriotic in the experimental group in the same period, the results did not have significance in Statistics.4. The expression of eutopic of p21WAF1 in the control group and experimental group showed significant differences(P<0.05). The expression of endometriotic in the control group and experimental group showed significant differences(P<0.05). The expression of eutopic and endometriotic in the experimental group did not have significance in Statistics.5. In the eutopic of experimental group Bcl-2 and p21WAF1 showed positive correlation P <0.05 r = 0.386, but Bax and p21WAF1 showed negative correlation P<0.05 r=-0.301. In the endometriotic of experimental group Bcl-2 and p21WAF1 showed negative correlation P <0.05 r = -0.320, and Bax and p21WAF1 showed negative correlation P<0.05 r=0. 290.Conclusion:1. In the normal menstrual cycle Bcl-2 expressed strongly in proliferative phase, but Bax expressed weakly. It inhibited endometrial apoptosis and promoted endometrial proliferation. Bax expressed strongly in secretory phase, but Bcl-2 expressed weakly. It promoted endometrial periodic shedding. They acted collaboratively on normal endometrium and regulated jointly its changes of shape and function.2. Bcl-2 had significant differences in the eutopic and endometrium of control group and experimental group through pairwise comparison in the three groups in the same period. It illustrated that the over-expression of Bcl-2 had a relationship with the occurrence and development of adenomyosis. Similarly, the low expression of Bax and p21WAF1 also played a role in the occurrence and development of adenomyosis.3. Bcl-2 and Bax both had obvious cyclical expression in normal endometrium. In the eutopic of adenomyosis we can see periodic expression, however, it was significantly higher than the expression in normal endometrium. But the periodic expression disappeared apparently in ectopic.4. Bcl-2, Bax, and p21WAF1 played a role of promoting mutually in the occurrence and development of adenomyosis.