| Endometriosis is one of the most enigmatic disease affecting women of reproductive age. It is associated with pelvic pain and infertility. Although it is not a malignant disorder, endometriosis exhibit cellular invasion, cellular proliferation and neoangiogenesis. Dispite being one of the most frequently encountered gynecological disease, the pathophysiology of endometriosis remains controversial. For the diagnose of endometriosis need a operation ( laparotomy or laparascopy) on patients to a biopsy , the exact prevalence of endometriosis in the general population is unknown. The prevalence of endometriosis in women with pelvic pain and/or infertility is estimated 20 to 70%. Some Theories have been propose to explain the pathogenesis of endometriosis: celomic metaplasis, metastasis, lymphatic and vascular dissemination, immune dystunction, growth factors and cancer gene. No single theory, however, can account for the location of ectopic endometrium in all cases of endometriosis. Clinical feather and in vitro experiments have suggest that endometriotic cells are invasive and able to metastasize, and that commom moluculars are operative in the invasion and cancer cells. This experiment collected endometria from the ectopic and eutopic endometrium from those cases with clinical endometriosis and from the cases with normal menstruate cycle. Then we test the Insulin-like growth factor system in these cases. We try to study the pathophysiology of endometriosis on mocular level, and find a new theropy method.In the experiment, Enzyme-linked Immuno Sorbent Assay(ELISA) were adopted to detect the levels of IGF-1 concentration in serum of endometriosis patients and normal women. There are no significant difference between endometriosis patients and normal women, no matter in secretive phase, or in proliferative phase. In the following experiment,immunohistochemical assays were adopted to detected the levels of IGF-1 and IGF-1 receptor(IGF-1R) in specmen of endometria from the ectopic and eutopic endometrium from those cases with clinical endometriosis and from the cases with normal menstruate cycle. The results showed that the positive expression of IGF-1 in specmen was yellow, in cellular plasma. We found that immunostaining score of IGF-1 in glandular epithelial cells were significantly higher than that in stromal cells in each groups, and in glandular epithelial cells of the endometria from the ectopic and eutopic endometrium from patients with clinical endometriosis were significant higher than those from the women with normal menstruate cycle, and in stromal cells of each groups there were no significant difference. The positive expression of IGF-1R in specmen was also yellow, in cellular plasma. We found that immunostaining score of IGF-1 in glandular epithelial cells were positive expression, in stromal cells were negative expression in each groups, and in glandular epithelial cells of the endometria from the ectopic endometrium from patients with clinical endometriosis were significant higher than those from the eutopic endometrium of patients and the normal endometrium of women with normal menstruate cycle, and in stromal cells of each groups there were no significant difference.We isolated the endometria and endometriotic stromal cell by centrifugation. The method was simpler than other methods. We purified and culture endometrium and endometriotic cells. The cells were detected through microscopy and immunohistochemical experiments. The purity of stromal cells were 95%. The cellular model than was used to investigate the therapy result of nafarelin with different concentration. We tested IGF-1 concentration in culture fluid under different drug concentration by ELISA. We found that both endometria and endometriotic stromal cells can secrete IGF-1 in vitro. IGF-1 concentration decreased under effective nafarelin concentration. In normal endometrium, IGF-1 concentration decreased significantly under 10ug/l nafarelin. In the ectopic and eutopic endometrium from the endometriosis patients,...
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