| Purpose:To investigate the expression of neural stem cellular RNA binding protein Musashi-1,cyclooxygenase COX-2,nuclear transcription factor Nrf-2 in the endometrial tissue of patients with adenomyosis(AM).And to explore the pathophysiology role and clinical mechanism of these cellular factors in adenomyosis progression.Methods:From March 2015 to March 2016,45 patients that diagnosed as adenomyosis by pathologic examination were enrolled into the study group,in Ningbo women and children hospital.Tissues were obtained from both eutopic and ectopic endometriums of the study group during proliferation phase.40 patients that diagnosed as uterine fibroids by pathology were enrolled into the control group.And tissues were also obtained from endometriums of the control group during proliferation phase.The expression levels of COX-2,Nrf-2,and Musashi-1 in the above endometrial tissues from the study group and the control group were examined by immunohistochemical assays.Correlations among these cellular factors' expression levels were also explored.All data in this study were analyzed by SPSS21.0.Measurement data is demonstrated as x±s.The mean values of the above cellular factors among varied tissues were compared using one-way ANOVA.T test was adopted to judge the significance between the study and the control groups.Correlation among the above cellular factors were tested using Pearson correlation analysis.Statistical significance was based on tests with P values lower than 0.05.Results:Musashi-1,COX-2,Nrf-2 were positive in endometrial tissue of patients with adenomyosis,and the expression levels were significantly higher than those of endometrioma(P<0.05).The expression of Musashi-1,COX-2 and Nrf-2 in endometrium was significantly lower than that in ectopic endometrium in patients with adenomyosis(P<0.05).Musashi-1,COX-2,Nrf-2 were positively correlated in ectopic endometrium(P<0.05).(1)Immunohistochemical assays show COX-2 positive expression at endometrial tissues of both study and control groups,with the highest level in ectopic endometrium of the study group,and the lowest level in endometrium of the control group.COX-2 expression in ectopic endometrium is significantly higher than the rest(P<0.05).COX-2 expression in basal layer of eutopic endometrium is significantly higher than that in non-basal layer(P<0.05).Differences were statistically significant.COX-2 in uterine adenomyosis group of ectopic endometrial glandular epithelial cells and stromal cells in the highest expression level,and in the uterine fibroids group of endometrial glandular epithelial cells and stromal cells expressed in lowest,the difference was statistically significant(P<0.05);The expression level of COX-2 in the endometrium of uterine fibroids was the lowest,and there was no difference in the expression of COX-2 in the glandular epithelium and interstitial cells(P<0.05).COX-2 in uterine adenomyosis group of ectopic endometrium tissue high expression of endometrial uterine fibroids group is significantly higher than in the expression of COX-2 levels(P<0.05),and the glandular epithelial cells of COX-2 expression level is higher than in the stromal cells of expression,the difference was statistically significant(P<0.05);At the same time,the expression level of COX-2 was significantly higher in the endometrial glandular epithelial cells in the adenomyosis group than in the interstitial cells,and the difference was statistically significant(P<0.05).(2)through the immunohistochemical detection of the Nrf-2 in each group were positive expression in endometrium,but found the Nrf group-2 in the womb gland myopathy highest expression level in ectopic endometrium,and expression in endometrial uterine fibroids group was the lowest,the positive expression of COX-2 in ectopic endometrium to be higher than in normal endometrium and in ectopic,on the base layer(normal)in ectopic endometrium and the positive expression than in the base layer of the normal endometrium and in ectopic,and P<0.05,differences were statistically significant.Uterine adenomyosis group in endometrial glandular epithelial cells and stromal cells of the Nrf-2 expression increased in the uterine fibroids group,difference was statistically significant,and the glandular epithelial cells express obvious higher than that of mesenchymal cells,the difference was statistically significant;Uterine adenomyosis group and ectopic endometrial glandular epithelial cells and stromal cells of the Nrf-2 expression compared with its corresponding cells in endometrium and myoma group Nrf-2 expression increased obviously,the difference was statistically significant(P<0.001),and the expression of glandular epithelial cells also significantly higher than the amount of interstitial cells,the difference was statistically significant(P<0.001).(3)through the immunohistochemical detection of Musashi-1 in each group were positive expression in endometrium,but found in the womb gland myopathy Musashi-1 set of ectopic endometrium in expression level,the highest and lowest expression in endometrial uterine fibroids group,positive expression in ectopic endometrium Musashi-1 to be higher than in normal endometrium and in ectopic,on the base layer(normal)in ectopic endometrium and the positive expression than in the base layer of the normal endometrium and in ectopic,and P<0.05,the differences were statistically significant.Uterine adenomyosis group in endometrial glandular epithelial cells and stromal cells Musashi-1 the expression of the uterine fibroids group increased,the difference was statistically significant,and the glandular epithelial cells express obvious higher than that of mesenchymal cells,the difference was statistically significant;Uterine adenomyosis group and ectopic endometrial glandular epithelial cells and stromal cells Musashi-1 the expression of its in ectopic and myoma group corresponding cell Musashi-1 significantly higher,the expression of Musashi-1 difference was statistically significant(P<0.001),and the expression of glandular epithelial cells also significantly higher than the amount of interstitial cells,the difference was statistically significant(P<0.001).(4)The expressions of Musashi-1 and COX-2 are high-positive correlated as the Phi correlation coefficient,that calculated by Pearson correlation analysis,showing r=0.691,P<0.001.The expressions of Musashi-1 and Nrf2 are moderate positive correlated as the Phi correlation coefficient showing r=0.472,P<0.05.The expressions of Nrf2 and COX-2 are high-positive correlated as the Phi correlation coefficient showing r=0.616,P<0.05.Conclusion:Musashi-1,COX-2,and Nrf-2 have high expressions at both ectopic and eutopic endometrial tissues of the patients with adenomyosis.And expression levels of the above three factors have positive correlations in these tissues. |
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