| Objective :The purpose of this study was to explose affective factors for endometrial histopathology in Polycystic Ovary Syndrome by analysizing endometrial histopathology, the relationship between incretional characteristic and endometrial histopathology, expression of ER, AR, IR IGF- I in endometrium association with endometrial histopathology.Methods: 34 PCOS patients served as study group, 30 patients with infertility or benign ovary tumer selected as control group, diagnostic curettage were preformed when they were seeking medical advice. The study group was divided into two groups further together 16 cases of endometrial hyperplasia and adenocarcinoma as group A, 18 cases of normal endometrium as group B. Sexual hormone,fasting plasma glucose , fasting insulin were determined, and Homeostasis model assessment of insulin resistance(HOMA-IR) were calculated. The expression of ER, AR IR, IGF-I in endometrium were detected by immunohistochemical methods, bingnResults:1. endometrial histopathology: The anovulatory endometrium were majority in PCOS. The prevalence of endometrial hyperplasia and adenocarcinoma was 47.06%(16/34), among them simple hyperplasia was 23. 53%(8/34), complex hyperplasia was 2. 94%(1/34), atypical hyperplasia was 14. 71%(5/34), endometrial adenocarcinoma 5. 88%(2/34);and normal endometrium was 52. 94%(18/34)that was 50. 00%(17/34)of proliferative phase and 2. 94%(1/34)secretory phase endometrium respectively. There were 21 cases of proliferative phase and 9 cases of secretory phase endometrium in control group.2. Serumal index (1) Estradiol level of group A, group B and control group were (55.13 ± 40.38) (52. 49 ± 26. 20) (77. 76 ± 56. 70)pg/ml respectively, no difference were found among them (P>0. 05);(2)There were dramatically higher testosterone in group A (56.44 ± 23.97)ng/dl and group B(67.69 + 22. 26)ng/dl compared with (35. 70 ± 14. 37)ng/dl in control group, (P<0. 01);(3) The ratio of LHtoFSH were (2.31 ± 1.10)and (2. 95 ± 1. 08)respectively in group A and group B, both of them were significantly higher than control group (0. 96 ± 0. 41), (P<0. 01);(4) HOMA-IR was (3. 96 ± 2.17) in group A that was higher than group B 组 (2.33 ± 1.38) and control group(1. 49 ± 0. 74) significantly, (P<0.01).3. The expression of ER AR, IR IGF- I in endometrium: (1) The expression of ER in endometrium of group A, group B and control group were (5.10 ± 4.34), (5.54 ± 4.07), (6. 42 ± 3.12)respectively , there were nosignificant difference, (P>0. 05);(2) The expression of AR in endometrium of group A^ group B and control group were (6. 76+4. 36), (6. 09±5.10), (6. 55 + 4.48) respectively, no difference were found among them (P>0. 05). The relationship between expression of AR in endometrium and serumal testosterone level was found , (r=0. 297, P=0. 017);(3) The expression of IR in endometrium in group A was (5. 12 + 3. 58) significantly higher than group B (1.86 + 2. 02)and control group(1. 32 + 1. 32), (P<0. 05), it was dominant for atypical hyperplasia and adenocarcinoma especially. The expression of IR in endometrium was association with HOMA-IR, (r=0.625, p=0. 000);(4) The expression of IGF- I in endometrium of group A (9.74 + 2.11) was significantly higher than control group(7.60+2. 05), (P<0. 01), especially higher in atypical hyperplasia and adenocarcinoma.Conclusion ￡ni&: (1) Endometrial histopathology in half of PCOS varied by hyperplasitic at a certain degree. It was possiblely relative with estrogen stimulation contantly. The insulin resistance and hyperinsulinemia was important to endometrial hyperplasia that plays a main role by up regulating the expression of IR in endometrium. The expression of IGF- I in endometrium was higher in PCOS suggest the estrogen and insulin stimulate the endometrium proliferation throughlGF-I. |
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