The Correlation Of Serum MMP-9, EGF And Uterine Myoma

Uterine Myoma/ Uterine Fibroid is the most familiar benign tumor in clinical gynecology of female genital, accounting for 52% in the female benign tumor. According to statistics, there are more than about 20% women with uterine myoma who are over the age of 30. The peak age of Chinese women who suffering from uterine myoma is between 41 and 50 years old, the morbidity is about 54.9%. Because most of the uterine myomas usually with little or even no symptoms, so the incidence of clinical report may be far below its true incidence. What’s more, with the development of the society and the change of the environment, the incidence of uterine myoma is increasing and the onset age is younger. At the present stage, the etiology and pathogenesis of uterine myomas is still not very clear, it involves a great deal of factors and steps. Several studies have shown that in addition to the estrogen and the progesterone, the family of matrix metalloproteinases(MMPs) and many kinds of growth factors have close contact with the occurrence and development of uterine myoma. Studies found that the formation of uterine is related to the formation and accumulation of extracellular matrix, well MMPs are thought to be an important family witch degradation of extracellular matrix, overall MMP-9 is considered to be the key enzyme of degradation and reconstruction. MMP-9 is one of the gelatin enzymes, its substrate is the main ingredient of the basement membrane and extracellular matrix-IV collagen type. For the past few years, studies have shown that MM P-9 has a close relationship with many kinds of benign and malignant gynecological diseases. Xiuping Zhou etc. found that the level of MMP-9 increased significantly in uterine myoma organization compared with normal uterine organization, it is shown that MMP-9 may have a certain relationship with the occurrence of uterine myomas. It is reported that the function of estrogen to uterine myoma is indirect, growth factor plays an important role as an intermediary factor. The main growth factors including epidermal growth factor(EGF), transfer growth factor beta(TGF-beta), insulin-like growth factor(IGF), basic fibroblast growth factor(b FGF) and platelet derived growth fact(PDGF), et al. studies have found that estrogen can stimulate estrogen reaction cell producing EGF, making the level of EGF and EGFR higher, leading to the occurrence and development of uterine fibroids to a certain extant. Through this research, we will probe into the correlation of the levels of serum Matrix metalloproteinase-9 as well as epidermal growth factor and the uterine myoma via determinating the serum level of matrix metalloproteinase-9(MMP-9) and epidermal growth factor(EGF) in patients with uterine myomas.Objective:This experiment by collecting the serum of patients suffering from uterine myomas and healthy people, determinating the serum level of matrix metalloproteinase-9(MMP-9) and epidermal growth factor(EGF) in these two teams and making them compare with each other; According to different clinical data, grouping patients with different types of uterine myomas in different groups, compare them within the case group, inorder to investigate the correlation of the levels of serum Matrix metalloproteinase-9 as well as epidermal growth factor and the uterine myoma, and to clarify the possibility of both factors as clinic examination indexes of uterine myoma.Methods:To select 62 patients treated by surgery in Chengde Center Hospital during 2013.01~2014.01, Postoperative pathological reports were uterine myoma and without other complications as case group. To choose 58 healthy people who had physical examination in the physical examination center of Chengde Center Hospital in the same period as control group. People of case group extracted venous blood in the preoperative morning well people of control group extracted venous blood in the physical examination day morning. Two groups of blood would be centrifugated and extract its serum in time, the serum samples would be stored in the refrigerator of-60℃,when the samples are enough,they would be measured uniformly. Determinate the serum levels of MMP-9 and EGF of these two groups respectively by the method of ELISA. Compare the serum level of these two factors between case group and control group. Considering the serum levels of MMP-9 and EGF may have relationship with the location, size, menstrual cycle, pathological type of uterine myomas. According to clinical data, divide the case group into different groups: according to the location of uterine myomas, the case group is divided into the group with submoucius myoma and group with intramural myoma; according to the diameters of myomas reported by B-type ultrasonic testing, take the median of them(57mm) as a dividing line, divide the case group into group Dmax≤57mm and group Dmax>57mm;according to different menstrual cycle of patients, the case group can be divided into group of follicular phase, luteal phase and menopause; According to different pathological type, divide the case group into cellular leiomyoma group and leiomyoma cell group, then compare the serum levels of these two factors within the case group. Statistical analysis would use SPSS17.0 statistic software. All data were expressed by X—±S, and they would be processed and analysis with one-way ANOVA or LSD-t test by SPSS17.0 statistic software, P<0.05 was regarded to have statistical significant difference.Results: 1 Comparison of serum levels of MMP-9 and EGF between case group and control group:The serum levels of MMP-9 and EGF in case group were higher than those of control group significantly(P<0.01). 2 Comparison of MMP-9 and EGF level between different location of uterine myomas:Comparing with the patients who sufferring from intramural myomas, the serum levels of MMP-9 and EGF of patients with submucous myomas are higher. The difference is significant(P<0.05). 3 Comparison of MMP-9 and EGF level between different diameters groups:The serum levels of MMP-9 and EGF did not have close correlation with maximum diameters of uterine myomas(P>0.05). 4 Comparison of serum MMP-9 and EGF levels within different menstrual cycle groups:The MMP-9 and EGF level of follicular phase group do not have statistical significant difference from luteal phase group(P > 0.05); The MMP-9 and EGF level of menopause group do not have statistical significant difference from not menopause group(P>0.05). 5 Comparison of MMP-9 and EGF level between different pathological type groups:The levels of MMP-9 and EGF were not correlated with pathological type of uterine myoma(P>0.05). 6 Through correlation analysis, serum level of MMP-9 and EGF have positive correlation between each other.Conclusion: 1 The levels of MMP-9 and EGF in case group were significantly higher than those of control group, it indicates that MMP-9 and EGF may be related to the pathogenesis of uterine myoma to some extant. 2 The levels of MMP-9 and EGF can be used as one of the clinic examination indexes, and they don’t have significant correlation with age and menstrual cycle. 3 The serum levels of MMP-9 and EGF may have significance in diffrerentiating the position of uterine myomas. 4 The levels of MMP-9 and EGF may not be used as the clinic examination indexes to judge the progression of uterine myoma. 5 Serum level of MMP-9 and EGF have positive correlation between each other, suggesting that these two factors in the pathogenesis of uterine fibroids may have synergistic effect with each other.