The Expression Of Endometrial EGFR And AR In PCOS And Adenocarcinoma Endometrium Patients

Objective : To analyze the effect of mechanical stimulation to the endometrium on the incidence of successful pregnancy during induction of ovulation with clomiphene citrate in polycystic ovary syndrome(PCOS). To investigate the expression of Epidermal growth factor receptor(EGFR) and Androgen receptors(AR) in normal menstrual cycles,in the endometrium of women with PCOS and adenocarcinoma endometrium and to discuss the relation between them.Methods: 54 PCOS infertile patients were studied in six menstrual cycle treated with clomiphene citrate.27 patients who were treated opration in the proliferative-phase .The remainig 27 patients were used as control.The expression of EGFR and AR were immunohistochemically investigated in 10 specimens of normal endometrium ,27 specimens of PCOS and 20 specimens of adenocarcinoma endometrium.Results: There were no significant differences between the two groups in the age and hormone level of the PCOS patients; Pregnancy in the treatment group were 37．37% which were significantly higher than those in the control group 11．11% .Using immunohistochemistry we found that the EGFR over expression in the endometrium of patients with adenocarcinoma endometrium.Women with PCOS and adenocarcinoma endometrium exhibited elevated endometrial AR expression compared to normal controls (P< 0．0167) , This increase was most apparent in glandular epithelium. AR expression was higher in the stromal of PCOS group compared to the other two groups (P< 0．0167 ) ;The AR expression correlated with serum androgens and BMI(T OR=1 .057, P =0．075 ; BMI OR=1 .493, P= 0．077) ;EGFR and AR expression in adenocarcinoma endometrium were positive correlated (rs=0．543, P=0．013) . EGFR and AR were positive correlation with adenocarcinoma histology grade(EGFR OR=l.869 , P=0．091 ;AR OR=2．043, P= 0．096) .Conclusions: Mechanical stimulation to the endometrium improves the pregnancy rate in PCOS patients during induction of ovulation with clomiphene citrate.Women with PCOS due to the concomitant increase in both serum androgens and elevations in endometrial AR. Androgen in PCOS endometrium may potentially be synergied with the epidermal growth factor to affect the endometrial cell signal transduction induce endometrial hyperplasia or even canceration.