Study On The Correlation Between TGF-β1 And CTGF And Adenomyosis Fibrosis

Objective: Adenomyosis(ADS)is a gynecological disease that causes dysmenorrhea,abnormal uterine bleeding,infertility and other symptoms,accompanied by increased organ fibrosis,and causes great physical and mental burden.The specific pathogenesis of Transforming Growth factor-β1(Transforming Growth factor-β1)and Connective Tissue Growth Factor(CTGF)were investigated in this paper.TGF-β1 expression in adenomyosis,and to explore the relationship between them and fibrosis.Methods:1.A total of 28 patients who received total hysterectomy or lesion removal for adenomyosis in the East Wing of the Second Hospital of Hebei Medical University from June 2016 to June 2019 were selected as the adenomyosis group.A total of 10 patients who underwent hysterectomy due to non-adenomyosis and grade Ⅲ cervical intraepithelial neoplasia during the same period were selected as the control group.All the cases were confirmed by pathological diagnosis,and interference factors were excluded.2.Preoperative dysmenorrhea scores of patients in the two groups were collected,and relevant scores were obtained by Visual analog scales(VAS),and the degree of fibrosis was preliminarily assessed by Masson staining.3.The expression of TGF-β1 and CTGF in tissues was detected by immunohistochemical staining,and the relationship between TGF-β1 and CTGF and fibrosis was discussed.Results:1.After Masson staining,the degree of fibrosis in ADS case group was higher than that in control group,and the difference of collagen fiber area ratio was statistically significant(P<0.05)after calculation comparison.Correlation analysis between collagen fiber area ratio and dysmenorrhea degree of patients in adenomyosis group showed a moderately positive correlation(r=0.42,P<0.05);2.TGF-β1 expression was concentrated in glandular epithelial cytoplasm and showed no difference in different menstrual cycles.The positive index suggested brown-yellow granular deposition,and the staining in the heterotopic intima group was stronger than that in the in-situ intima group and the normal intima group,with statistical significance(P<0.05).There was no significant difference between the two groups(P>0.05);3.The expression degree of CTGF was stronger in glandular epithelium than in stroma.The ectopic group was higher than the in-situ intima group and the control group,and the difference was statistically significant(P<0.05).The staining intensity in the endometrium group was lower than that in the control group,and the difference was statistically significant(P<0.05);4.The correlation between CTGF and TGF-β1 in the case group was r=0.5,(P<0.05),showing a moderately positive correlation.The difference was statistically significant.Conclusions:1.The expression of connective tissue factor and transforming growth factor-β1 indicated that both of them were involved in the process of muscular fibrosis in adenomyosis.2.Connective tissue factor and transforming growth factor-β1 are significantly correlated in the process of muscular fibrosis in adenomyosis,which may produce synergistic effects.3.It was concluded that the degree of muscular fibrosis in adenomyosis was positively correlated with dysmenorrhea,and fibrosis may be one of the factors causing dysmenorrhea.