The Study Of Vascular Endothelial Growth Factor And Matrix Metalloproteinases-11 In Endometrium Of Hypomenorrhea

Objective: It was generally considered that hypomenorrhea was caused by endometrium adhesions and scars mostly. But there were no endometrial adhesions or scars in some hypomenorrhea patients by hysteroscopy. The values of sexual hormones were normal and hormone replacement thrapy to these patients was useless. The etiopathogenisis in this sort of hypomenorrhea is unknown. This study was aimed to evaluate the expression of vascular endothelial growth factor(VEGF), blood vessel marker(CD34), matrix metalloproteinases-11(MMP-11)and its tissue inhibitor (TIMP-1) in the endometrium of hypomenorrhea, and to find the differences of microvessel density (MVD) in endometrium of normal group and hypomenorrhea group, and to explore the etiopathogenesis of hypomenorrhea.Methods: 40 hypomenorrhea cases with undetermined etiological factor were studied, with 20 cases of proliferative phase endometrium, and 20 cases of secretory phase endometrium.Another 40 cases were collected of normal endometrium including 20 cases of proliferative phase endometrium and 20 cases of secretory phase endometrium were enrolled as control.(1) The expressions of VEGF,CD34,MMP-11 and TIMP-1 were determined by immunohistochemical S-P assay. (2) The microvessel density (MVD) in endometrium of hypomenorrhea and normal endometrium was detected by quantitative determination. (3) VEGF expression in the endometrium of hypomenorrhe and normal endometrium was also determined by Western blot.Results:(1) VEGF was expressed in both proliferative and secretory phase in normal endometrium. VEGF expression in endometrial glandular cells was significantly lower than that of normal ones in proliferative phase(P<0.05) and secretory phase(P<0.05). However, in stromal cells , there was no significiant difference between hypomenorrhea and in normal endometrium either in the proliferative (P>0.05) or in the secretory phase(P>0.05). (2) The MVD of CD34 in endometrium of hypomenorrhea was lower than that of normal subject in proliferative phase(P<0.01) and secretory phase(P<0.01). VEGF was in positive correlation with MVD in glandular and stromal cells of normal endometrium; In the hypomenorrhea group, VEGF was also in positive correlation with MVD in glandular and stromal cells. (3) MMP-11 expression in endometrial glandular cells (P<0.01) and stromal cells(P<0.05) of hypomenorrhea was lower than that of normal subjects in proliferative phase. In endometrial glandular cells, there was no significiant difference between hypomenorrhea and in normal endometrium in the secretory phase(P>0.05),but MMP-11 expression in stromal cells was significantly lower than that of normal ones in secretory phase(P<0.05).TIMP-1 expression in endometrial glandular cells was lower than that of normal subjects in the proliferative phase (P<0.05) and the secretory phase (P<0.05). There was no significiant difference of TIMP-1 expression in stromal cells between hypomenorrhea group and normal one in the proliferative phase (P>0.05) and secretory phase (P>0.05). (4) VEGF was dectected by Western blot in normal endometrium. There was no significant difference between between the expression in proliferative phase and in secretory phase (P>0.05).Compared with normal endometrium,VEGF expression was significant lower in proliferative phase and secretory phase in the endometrium of hypomenorrhea(P<0.01).Conclusions: (1)VEGF expression in endometrial glandular cells of hypomenorrhea was lower than that of normal subjects. The MVD was lower in the endometrium of hypomenorrhe than in normal subject during the proliferative phase and secretory phase. It showed that the activity descenting of blood vessel in endometrium was the important reason of hypomenorrhea.(2) MMP-11 might participate in the reconstruction and generation of endometrium.