Research On The Emmprin, MMP-9 And C-fos In Ectopic And Eutopic Endometrium From Women With Endometriosis And Its Biological Significances

Background:Endometriosis(EMs) is a common gynecologic disease, but its etiology and pathogenesis is not clear. Sampson’s theory of retrograde menstruation is the most widely accepted theory among several theories to explain this disease. This theory explains that the endometrial tissue (glandular epithelium and stroma) which reaches the pelvic peritoneum with retrograde menstruation,implanting and growing on ovaries,uterosacral ligament and other pelvic organs subsequently.It can not explain 80%-90% of women who have menstrual blood reflux phenomenon, with only 10%-15% of them suffer from the disease. Recently the researches found that blood reflux is a risk factor for EMs. The endometrial tissues which reach the pelvic peritoneum,must have the abilities to degrate ECM and generate new blood vessels, which support their survive,implant,grow and produce lesions. The extracellular matrix metallo proteinase inducer(EMMPRIN), matrix metalloproteinases 9(MMP-9) and c-fos proteins may play important roles in the pathogenesis and progression of EMs.Objective:We detected the expression levels of EMMPRIN、MMP-9、c-fos proteins on eutopic and ectopic endometrial tissues from patients with endometriosis and control endometrial tissue (CE) from patients without endometriosis, in order to investigate the expressions and significances of EMMPRIN, MMP-9 and c-fos in EMs.Meterials and Methods:The ectopic endometrial tissues (ECE group) were obtained from the patients with ovarian endometrioma who underwent laparoscopic or transabdominal surgery, and the matched eupotic endometrial tissues (EUE group) were collected from the patients who underwent hysterectomy simultaneously among those patients. The control endometrial tissues (CE group) were collected from the patients with uterine myomas and without endometriosis,who underwent hysterectomy. The expression levels and distributions of EMMPRIN、MMP-9、c-fos proteins in the ECE group, EUE group and CE group were analyzed by immunohistochemical methods and image analysis methods.Results:1. The expressions and distributions of EMMPRIN,MMP-9 and c-fos proteins in endometrium from ECE group,EUE group and the CE group can be detected. EMMPRIN and MMP-9 were mainly expressed on endometrial glandular epithelium and cytoplasm of interstitial cells.C-fos proteins were mainly expressed on cytoplasm of endometrial glandular epithelium and interstitial cells.2. The expressions of EMMPRIN and MMP-9 in ECE group were significantly higher than those in EUE group and CE group (P<0.05).The expressions of EMMPRIN and MMP-9 in EUE group were significantly different from those in CE group (P<0.05). In these three groups, the expressions of EMMPRIN. MMP-9 had no periodic changes(P>0.05).3. The expressions of c-fos in ECE group and EUE group were significantly higher than those in CE group (P<0.05). There were no significant differences in the expressions of c-fos in ECE and EUE groups (P>0.05). The expressions of c-fos proteins in the ECE group, EUE group and the CE group showed periodic changes, and the expressions of c-fos proteins in the proliferative phases were significantly higher than those in the secretory phases(P<0.05).Conclusions:1. EMMPRIN and MMP-9 were expressed on the ECE group,EUE group and the CE group. The expression intensities of EMMPRIN and MMP-9 were ECE group> EUE group> CE group. The differences among these three groups were statistically significant (P<0.05). In these three groups, the expressions of EMMPRIN,MMP-9 were not significantly different in the different menstrual cycles(P>0.05).2. The expressions of c-fos proteins in ECE group and EUE group were similar, and the differences were not statistically significant (P>0.05). The expressions of c-fos proteins in the ECE group and EUE group were significantly higher than those in the CE group (P<0.05). In these three groups, the expressions of c-fos proteins had periodic changes. The expression levels of c-fos proteins in the proliferative phases were significantly higher than those in the secretory phases.3. EMMPRIN,MMP-9 and c-fos may be involved in the pathogenesis of endometriosis,and may play important roles to promote the invasion and cultivation of ectopic endometrium.