The Expression And Role Of Osteopontin In The Tissue, Serum And Peritoneal Fluid Of Patients With Endometriosis

BackgroundEndometriosis is a common, chronic gynecological disorder associated with pelvic pain and infertility, Which may affect around 10%-15% women of reproductive age. Endometriosis is considered a benign disease but shares some features with cancer, such as propensity to invasion, unrestrained growth, neoangiogenesis, and distant spreading. A number of studies on endometriosis have been done, but the researchers and the clinical doctors still can not completely illuminate it. However,the researchers consider some features with cancer such as adhension, invasion, angiogenesis, unrestrained growth, reduction of apoptosis important to mechanism of endometriosis. Osteopontin , a glycosylated protein with phosphorylation,has a number of biological activities such as regulation of osteoblast,osteoclast adhension to bone tissue,neural development,vascular remodeling,smooth muscle cell proliferation, and invasion and spreading of cancer. Osteopontin is considered a important tumor metastasis-related genes in recent years which is over expressed in stomach cancer,hepatic carcinoma,colorectal cancer,ovarian cance and other tumors.In recent years, more and more researchers pay attention on the role of osteopontin in endometriosis and they surmise the mechanism of osteopontin in endometriosis similar to that of cancer. Therefore, the correlation between osteopontin and endometriosis has become a worldwide research.ObjectiveTo study the expression of osteopontin(OPN)in tissue, serum and peritoneal fluid of patients with endometriosis. Investigate the mechanism of endometriosis.MethodsThe tissue,serum peritoneal fluid from 40 cases with endometriosis(studygroup)and 25 cases with uterine fibroids(control group) that underwent laparoscopic surgery were collected.There were 20 cases eutopic endometrium collected by total hysterectomy as the consolidation adenomyosis and uterine fibroids.Eutopic endometrium, 11 cases were proliferative phase endometrium, 9 cases were secretory phase. Control group, 11 cases were proliferative endometrium, 14 cases were secretory phase . By American Fertility Society (AFS) 1985 revised the stages of endometriosis,4 cases of EMS patients were stage I, 11 cases were stageⅡ, 9 cases were stageⅢ, 16 cases were stageⅣ.The expression of OPN in ectopic endometrium,eutopic endometrium and endometrium from control group was measured by immunohistochemistry. The preoperational level of serum and peritoneal fluid OPN was measured by enzyme-linked immunosobent assay(ELISA).Data were analyed according to disease stages and phase of the menstrual cycle.Results1. OPN was expressed in the gland epithelium cells.The expressions of OPN in ectopic endometrium and eutopic endometrium of endometriosis were higher than that of control group (P<0.05). The preoperational level of serum OPN was significantly higher (46.68±16.38)ng/ml in 40 patients with endometriosis than that of control group (P<0.05). The level of peritoneal fluid OPN in patient with endometriosis(47.47±15.90)ng/ml was also higher than that of control group (P<0.05).2. The expressions of OPN in ectopic endometrium,eutopic endometrium and the preoperational level of serum and peritoneal fluid OPN in patients with endometriosis ofⅢ～Ⅳstadges were significantly higher than that in patients with endometriosis of I～Ⅱstadges(P<0.05).3. There was no change of ectopic endometrium from proliferative to secretory stage. The expressions of OPN in endometrium of secretory phase were significantly higher than that of proliferative phase.4. Positive correlation was found between the expression of OPN in serum and peritoneal fluid of patients with endometriosis (P<0.05).There was positive correlation between the expression of OPN in serum and peritoneal fluid of patients of control group (P< 0.05).Conclusions1. OPN is over expressed in ectopic endometrium and eutopic endometrium of patients with endometriosis.The expressions of OPN in ectopic endometrium and eutopic endometrium in patients with endometriosis ofⅢ～Ⅳstadges were significantly higher than that in patients with endometriosis of I～Ⅱstadges,which suggests that OPN may be correlated with pathogenesis of endometriosis.2. The expressions of OPN in endometrium of secretory phase were significantly higher than that of proliferative phase.It sugguested that the expressions of OPN in endometrium may be regulated by estrogen and progesterone.3. The higher levels of OPN in the serum and peritoneal fluid from patients with endometriosis has a very important diagnostic value.