Study On Expression Of P53，p21，MDM2in Endometriosis And Adenomyosis And Their Clinical Signincance

BackgroundObjectivep53, p21and MDM2are oncoproteins that regulate the cell cycle. The purpose of thisstudy was to examine the distribution of p53, p21and MDM2oncoprotein expression inendometriosis and in adenomyosis, to discuss the occurrence and development of therole of p53, p21, MDM2and apoptosis in endometriosis and provide a theoretical basisfor clinical diagnosis and treatment。MethodsTissue samples from30women with pathologically confirmed ovarian endometriosisand29women with pathologically confirmed adenomyosis and29women withpathologically confirmed normal endometrium were analyzed. Expression of p53,p21and MDM2oncoproteins was assessed by immunohistochemical nuclear staining,analyze the relationship between p53、p21、MDM2expression and apoptosis.Results1. The expression of p53proteins in different tissues：p53product as brown particles,distributed in the nucleus。In29cases of normal endometrium，18cases of proliferativephase of p53positive expression of three cases，The positive rate of p53was16.67%。11cases of secretory phase p53expression of eight cases, the positive rate ofp53was72.73%。There was significant difference between two group（χ~2=9.114P=0.003），secretory phase was higher than proliferative phase。In30cases of ovarianendometriosis，19cases of proliferative phase of p53positive expression of two cases，the positive rate of was10.53%，11cases of secretory phase p53expression of twocases, the positive rate of p53was18.18%，There was no significant differencebetween two group（χ~2=0.353，P=0.552）。In29cases of adenomyosis，15cases ofproliferative phase of p53positive expression of two cases，The positive rate of was 13.33%。14cases of secretory phase p53expression of two cases, the positive rate ofp53was14.29%，There was no significant difference between two group（χ~2=0.006P=0.941）。the positive rate of p53in normal endometrium、ovarian endometriosis、adenomyosis were37.93%、13.33%、13.79%，the positive rate of p53in normalendometrium was higher than that in ovarian endometriosis（χ~2=4.706P=0.03），thepositive rate of p53in normal endometrium was higher than that in adenomyosis（χ~2=4.406P=0.036），There was no significant difference between ovarian endometriosisand adenomyosis patients（χ~2=0.003， P=0.959）。2. The expression of p21proteins in different tissues：p21product as brown particles,distributed in the nucleus。The positive rate of p21in normal endometrium、ovarianendometriosis、adenomyosis were31.03%、10%、6.89%，the positive rate of p21innormal endometrium was higher than that in ovarian endometriosi（sχ~2=4.027P=0.045）,the positive rate of p21in normal endometrium was higher than that in adenomyosis（χ~2=5.479P=0.019）， There was no significant difference between ovarianendometriosis and adenomyosis patients（χ~2=0.183P=0.669）。3.The expression of MDM2proteins in different tissues：MDM2product as brownparticles, distributed in the nucleus and（or）cytoplasm, the positive rate of MDM2innormal endometrium、ovarian endometriosis、adenomyosis were0.03%、53.33%、48.24%，the positive rate of MDM2in normal endometrium was lower than that inovarian endometriosis（χ~2=17.89P=0.000）, the positive rate of MDM2in normalendometrium was lower than that in adenomyosis（χ~2=15.19P=0.000），There was nosignificant difference between ovarian endometriosis and adenomyosis patients（χ~2=0.151P=0.698）。4.The relationship between p53, p21and MDM2expression in ovarian endometriosis：In30cases of ovarian endometriosis，the expression of p53and p21were decreasedwhile the expression of MDM2was elevated，the expression of p53and p21in ovarianendometriomas were positively correlated with each other（r=0.611，P<0．01），the expression of p53and MDM2in ovarian endometriosis were negatively correlatedwith each other（r=-0.541，P<0．01），the expression of p21and MDM2in ovarianendometriomas were not significantly correlated with each other （r=0.404，P＞0．05）。Conclusion1. p53, p21and MDM2are important apoptosis regulatory genes。Comparison with thecontrol group, normal endometrium, the expression of p53and p21proteins in ovarianendometriosis and adenomyosis were significantly lower and the expression of MDM2was significantly higher。This result indicate abnormal expression of p53、p21、MDM2in endometriosis and adenomyosis play an important role in ectopicendometrial cell proliferation，it provides a new theoretical basis in apoptosis inendometriosis and also provide a new target for treatment of endometriosis from the cellapoptosis for future research。2. The expression of p53proteins in proliferative phase was higher than that in secretoryphase in normal endometrium，while there was no significant difference betweenovarian endometriosis and adenomyosis patients，this result indicate normalendometrial cells have periodic and spontaneous apoptosis，endometriomas andadenomyosis cells Lose normal cycle of apoptosis。The expression of p53and p21in ovarian endometriosis were positively correlated witheach other, the expression of p53and MDM2in endometriomas were negativelycorrelated with each other, the expression of p21and MDM2in endometriomaswere not significantly correlated with each other. This result indicate p53and p21promote each other, they have synergistic effect in the development ofendometriosis。p53and MDM2inhibit each other, they restraint and mutual eachother in the development of endometriosis。 Although p21and MDM2are involvedwith the development of endometriosis， they may play a role in different signalingpathways. 3. The expression of p53、p21、MDM2proteins in ovarian endometriosis were similarwith that in adenomyosis，the difference was not significant， this result indicate themechanism of endometriosis might be similar with adenomyosis at some aspects．...