Expression And Signification Of C-myc In Ectopic And Eutopic Endometria In Aenomyosis

Objective: adenomyosis used to be called inherent endometriosis,is a benign disease process defined by the presence of endometrialglands and stroma inside of the uterine smooth muscle.Adenomyosis affects women from adolescence to postmenopausal,especially women in reproductive age. Infertile, dysmenorrhea,menorrhagia, anaemia are the common symptoms, which affectpatients' everyday lives. In recent years, apoptosis is becomingmore and more emphasized, many investigation show that there isatoptosis in adenomyosis which is managed by some regulatinggenes. The purpose of this study was to evaluate the expression ofc-myc in adenomyosis, to discuss the important affect ofapoptosis-regulating gene.Method:From March 2004 to August 2005, 40 women who wereoperated for adenomyosis at the Department of Obstetrics andGynecology of China and Japan Union Hospital, Jilin University,were enrolled into this study. The mean age was 41.2 years (range38~43,Including 20 cases in the proliferative phase,20 cases in thesecretory phase) without hormone used history. Eutopic and ectopicendometrial tissue were obtained during surgery, adenomyosis wasconfirmed by pathology. There was no difference in age from allgroups(P>0.05), age as a mixed factor could be excluded.In the control group,eutopic endometrial specimens wereobtained by curettage from 40 women for emmenia disorder, meanage was 43.7 years (range 35~54, adenomyosis and other diseasewere excluded, Including 25 cases in the proliferative phase,15cases in the secretory phase ).The tissues were fixed in neutral-buffered 10% formalinsolution after numbered. The samples were cut into blocks,eparaffinized,4-5 um sections of tissue were cut. After confirmedby pathology again, The sections were stained immunohistochemi-cally,stained with diaminobenzidine (DAB) and counterstainedwith haematoxylin. In each run,a section with strong c-mycstaining was routinely included as a positive control. Tennon-overlapping fields of view were examined per biopsy in asystematic random sampling pattern (magnification x400). Surfaceepithelial cells or ectopic endometrial glandular epithelial cellswere assessed. The frequency was defined as 0, 1,2, 3 and 4 whenthe number of positive cells in the endometrium in each sectionwas <5%,5–20%, 20%~50%, 50% ~75% and >75% respectively.Result:No expression of c-myc were found in surface andglandular epithelia of the control group. However, in patients withadenomyosis expression of c-myc in surface epithelial cells orectopic endometrial glandular epithelial cells were obviouslyhigher than that in the control group.1.Expression of c-myc in surface and glandular epithelia ofthe control group.Positive expression of c-myc is shown as brown and yellowgranule in cytoplasm and nuclear of glandular epithelia, mainly incytoplasm. No positive expression was found in endometrium ofthe control group( table1, fig.1).2. Expression of c-myc in eutopic endometriumPositive expression of c-myc was shown in cytoplasm andnuclear of glandular epithelia of eutopic endometrium, with a rateof 35%, there was obvious difference compared with the controlgroup (P<0.01), 8 cases were positive out of 20 cases ofproliferative phase, 6 cases were positive out of 20 cases ofsecretory phase, there was no obvious difference in this twophase(P>0.05). the expression of c-myc didn't change during themenstrual cycle. The expression of c-myc of eutopic endometriumwas higher than that of the control group.( table1, fig.2).3.the expression of c-myc in ectopic endometriumPositive expression of c-myc was shown in cytoplasm andnuclear of glandular epithelia in ectopic endometrium, with a rateof 62.5%, there was obvious difference compared with the controlgroup (P<0.01), there was obvious difference compared with theeutopic endometrium also(P<0.05). 70% were positive inproliferative phase, 55% were positive in secretory phase, therewas no obvious difference in this two phase (P>0.05). table1, fig.2Conclusion :1.No expression of c-myc were found in surface and glandularepithelia of the control group.2.c-myc was excessively expressed in eutopic and ectopicendometrium in adenomyosis.3.c-myc correlate with the occurrence and progression ofadenomyosis,Expectation :Endometrium may cooperate with polygene, many factors andmany steps,it involves many factors such as gene breaking,immunology changing,physiological and biochemistry chaging,hormone abnormity adjusting and etc. The over expression ofc-myc is only one facet of those. Lucubrating c-myc may open outthe mechanism of endometriosis, on the other hand,it may providethe therapy with new tactics. On the other hand,the variety ofc-myc expression in different period of adenomyosis,and how itexpresses at the ectopic endometrium in other position ofadenomyosis still need more research. The degree of apoptosismay correlate to the activity and expression of c-myc protein,inhibiting the expression of c-myc gene to restart apoptosis may beapplied to treat adenomyosis. Furthermore,c-myc has the potentialto become an marker for patients with adenomyosis, it is importantto set down individual project in adenomyosis therapy accordingthe various expression of c-myc.