| Section OneThe expression of serum Apelin in patients with endometrial hyperplasia and carcinogenesisObjective: Investigate the expression of serum Apelin in patients with endometrial hyperplasia and carcinoma and patients with normal endometrium,observe the relationship between endometrial hyperplasia and clinical features to further explore the relationship between serum Apelin level and endometrial hyperplasia and carcinoma.METHODS: Patients who underwent hysteroscopy or curettage were enrolled in the Tianjin Medical University General Hospital from March 2018 to October 2019,36 patients who underwent hysteroscopy or curettage because of abnormal uterine bleeding or abnormal ultrasound and were diagnosed as endometrial hyperplasia or endometrial carcinoma by pathology were included in the case group,49 patients who underwent hysteroscopy or curettage because of septate uterus or intrauterine adhesions and were diagnosed as proliferative endometrium or secretory endometrium by pathology were included as control group.Patients with other endocrine disease or other cancers were excluded,patients who used hormone drugs or drugs influencing blood glucose and lipoid in the past 3 months were excluded.Relevant clinical data were collected,fasting blood glucose and insulin levels were measured,and serum Apelin levels were determined by ELISA.RESULT:1.The level of serum Apelin(358.25±236.71 ng/ml)in the case group was significantly higher than that in the control group(151.97±96.32 ng/ml)(P< 0.001).2.According to the degree of endometrial hyperplasia,the patients were further divided into control group(n=49),endometrial hyperplasia without atypia group(n=25),atypical hyperplasia and endometrial carcinoma group(n=10).The level of serum Apelin in atypical hyperplasia and endometrial carcinoma group(413.80±295.29ng/ml)and endometrial hyperplasia without atypia group(336.89±212.94ng/ml)were significantly higher than that in control group(151.97±96.32 ng/ml)(P < 0.05).The level of serum Apelin in atypical hyperplasia and endometrial carcinoma group(413.80±295.29ng/ml)was higher than that in endometrial hyperplasia without atypia group(336.89±212.94ng/ml),but there was no significant difference(P =0.597).3.Apelin and other indexes were analyzed and the results showed that the level of serum Apelin was positively correlated with BMI(r=0.273,P=0.011),fasting plasma glucose(r=0.236,P=0.030).4.A binary logistics regression analysis of risk factors in endometrial hyperplasia was completed,which showed that a high concentration level of serum Apelin(P<0.001)and obese(P=0.002)both were independent risk factors of endometrial hyperplasia.CONCLUSION:1.The level of serum Apelin in patients with endometrial hyperplasia and carcinoma was increased and the concentration was increased with the progression of endometrial hyperplasia.Apelin in serum may be involved in endometrial hyperplasia and carcinogenesis.2.Level of serum Apelin might be influenced by BMI,fasting blood glucose,Section TwoThe expression of Apelin in endometrial tissue of patients with endometrial hyperplasia and CarcinomaObjective: To investigate the expression of Apelin in endometrium of patients with endometrial hyperplasia and carcinoma.To analyze the correlation between Apelin expression in endometrial tissue and serum Apelin level and other clinical indicators,and to explore the possible pathogenesis.METHODS: patients who underwent hysteroscopy or curettage were enrolled in the Tianjin Medical University General Hospital from March 2018 to October 2019,54 patients who underwent hysteroscopy or curettage because of abnormal uterine bleeding or abnormal ultrasound and were diagnosed as endometrial hyperplasia or endometrial carcinoma by pathology were included in the case group,80 patients who underwent hysteroscopy or curettage because of septate uterus or intrauterine adhesions and were diagnosed as proliferative endometrium or secretory endometrium by pathology were included as control group.Patients with other endocrine disease were excluded,patients who used hormone drugs in the past 3 months were excluded.Relevant clinical data were collected,fasting blood glucose and insulin levels were measured,the level of Apelin in endometrium was detected by Immunohistochemistry,the relationship between serum Apelin level and endometrial Apelin expression was analyzed through measuring by Image-Pro Plus.Results:1.Apelin is mainly expressed in the cytoplasm of glandular cells in endometrium,but less in the stroma of endometrium.2.The level of endometrium Apelin in the case group(0.17±0.20)was significantly higher than that in the control group(0.006±0.008)(P<0.001).3.According to the degree of endometrial hyperplasia,the patients were further divided into control group(n=80),endometrial hyperplasia without atypia group(n=36),atypical hyperplasia and endometrial carcinoma group(n=18).The level of Apelin in atypical hyperplasia and endometrial carcinoma group(0.24±0.22)and endometrial hyperplasia without atypia group(0.06±0.11)was significantly higher than that in control group(0.006±0.008)(P < 0.05),The level of Apelin in atypical hyperplasia and endometrial carcinoma group(0.24±0.22)was significantly higher than that endometrial hyperplasia without atypia group(0.06±0.11),but the difference was not statistically significant(P=0.423).4.Apelin and other indexes were analyzed and the results showed that the level of serum Apelin was positively correlated with serum Apelin level,(r=0.339,P=0.028)、fasting plasma glucose(r=0.541,P<0.001)、HOMA-IR(r=0.444,P=0.001).CONCLUSION:1.Apelin is mainly expressed in the cytoplasm of glandular cells in endometrium,but less in the stroma of endometrium.2.The level of endometrium Apelin was increased in the endometrial hyperplasia and carcinoma,suggesting that endometrium Apelin might be involved in the progression of endometrial hyperplasia and carcinoma.3.Apelin expression in endometrial tissues was positively corelated with concentration level of serum Apelin,which revealed that Apelin expression in endometrial tissues could be influenced by concentration level of serum Apelin. |
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