Study On The Expression Of TrkA,NPY In Adenomyosis And Their Relationship With Dysmenorrhea

Objective:To study the expression of TrkA and NPY in eutopic and ectopic endometrium with adenomyosis and normal endometrium of the patients. To discuss the relation-ship between them and adenomyosis and the pain of adenomyosis. To study the pathogenesis of adenomyosis and dysmenorrhea of adenomyosis. It will provide a theoretical guidance for clinical treatment.Methods:Use the methods of immunohistochemistry S-P to examine the expression of TrkA and NPY proteins in the glandular and stromal cells of the eutopic and ectopic endometrium of adenomyosis in 48 patients (28 in the proliferative phase and 20 in the secretive phase; 5 patients in no dysmenorrhea group,10 patients in mild dysmenorrhea group,25 patients in moderate dysmenorrhea group,8 patients in serve dysmenorrhea group) and to examine the expression of TrkA and NPY proteins in the nomal endometrium from 15 hysteromyoma patients in no dysmenorrhea group(9 in the proliferative phase and 6 in the secretive phase). We study the difference of the different group and different menutrual phase in the same group. According to different levels of expression of TrkA and NPY in adenomyosis patients with dysmenorrhea, their role and correlaion are analyzed in the development of adenomyosis and the pain of adenomyosis.Result:1. TrkA(1) TrkA protein was most expressed in endometrial epithelial cells. There was no significant difference between proliferative and secretory phase(t=1.144,.P>0.05). There is no obvious periodicity.(2) Expression of TrkA in patients with adenomyosis had no significant differences in comparing proliferative phase with secretory phase in eutopic endometrium (t=0.633,P>0.05). Expression of TrkA in patients with adenomyosis was significantly elevated in comparing proliferative phase with secretory phase in ectopic endometrium (t=5.830,P<0.05). There were no significant differences in the eutopic and ectopic glandular cells and stromal cells (t=0.378,P>0.05).(3) Expression of TrkA in adenomyosis group was significantly elevated in the eutopic glandular cells and stromal cells, ectopic glandular cells and stromal cells comparing with the normal group (t=2.715,P<0.01;t=3.416,P<0.01).(4) Expression of TrkA in adenomyosis group was significantly elevated in comparing the no-pain group with the pain group P=0.049(P<0.05). It was significantly elevated in comparing the mild pain group with the the moderate and severe pain group P=0.035(P<0.05). Furthermore the elevation is accompanied with the severity of pain. There was a positive correlation.2. NPY(1) NPY protein was mainly expressed in the endometrial stromal cells and the vascular endothelial cells. It was also partly expressed in the glandular cell. Expressi-on of NPY in the normal endometrial glands was elevated in comparing the secretory phase group with proliferative phase group(t=2.367,P<0.05).(2) Expression of NPY in patients with adenomyosis was significantly elevated in comparing the eutopic glandular cell and stromal cells with ectopic glandular cell and stromal cells(t=2.077,P<0.01). There was significant difference between the secretory phase and the proliferative phase in eutopic and ectopic endometrium (t=3.608,.P<0.05;t=4.812,P<0.05).(3) Expression of NPY in adenomyosis group was significantly elevated in the eutopic glandular cells and stromal cells, ectopic glandular cells and stromal cells comparing with the normal group (t=2.837,P<0.05;t=2.163,P<0.05).(4) Expression of NPY in adenomyosis group was significantly deceased in comparing the no-pain group with the pain group P=0.043(P<0.05). It was significantly decreased in comparing the mild pain group with the moderate and severe pain group P=0.024(P<0.05). Furthermore the decreasing is accompanied with the severity of pain. There was a negative correlation.3. There were no correlation between expression of TrkA and expression of NPY in the pain group of adenomyosis (r=0.195,P>0.05).Conclusions:1. There was a relationship between the expression of TrkA and the occurrence and development of adenomyosis. Physical and chemical characteristics of the eutopic endometrium may play a decisive role on the ectopic endometrium.2. Expression level of NPY and the incidence of adenomyosis has a close relationship. Stromal cells may be the initiating cause of adenomyosis.3. High expression of TrkA in adenomyosis patients is an important reason of the pain patients with adenomyosis. The expression of NPY showed a reverse trend. Studies of the relationship between them may reveal a deeper mechanism of adenomyosis and dysmenorrhea of adenomyosis.4. The studies may provide new strategies for adenomyosis and dysmenorrhea of adenomyosis. It may provide a new idea of diagnosis and treatment to adenomyosis.