| Endometriosis ,a benign disorder, is a common gynecologic condition characterized by metastasis and implantation of endometrial - like tissue. The pathogenesis of endometriosis remains unclear. Samponson, in his theory of retrograde menstruation that had won general recognition, believed that the endometrial cells and fragments sheded during the menstrual period and were transported through the fallopian tubes into the peritoneal cavity where they implanted, proliferated and developed into endometriotic lesions. Recently, studies in women with endometriosis have shown functional changes in several immunologic components in the peritoneal fluid (PF) and the sera of the patients. It has been indicated that many cytokines and growth factors are involved in endometrial cell implantation and proliferation, and the formation of the endometriotic lesions. Those factors are essentially responsible for decreased immunologic surveillance , recognition and demolishment of the ectopic endometrial cells , making the implantation of ectopic endometrial tissues possible. Growth factors may also play a crucial role in the pathogenesis of endometriosis by independendy stimulating cell growth or differentiation.Hepatocyte growth factor ( HGF) was first identified in the serum of hepate-ctomized rats, and was later isolated from human serum. As a mesenchymade-rived pleiotropic factor that mediates mesenchytmal - epithelial interactions, HGF acts as a mitogen, morphogen and chemoattractant for epithelial cells, and is thought to be also involved in the regeneration or reconstruction of epithelial cell structure. In vitro experiments have demonstrated that HGF is capable of inducing gland formation in endometrial epithelium. Endometrial stromal cellsfrom women with endometriosis have also been found to secrete large amount of HGF in vitro, which may contribute to regeneration of the endometrial glands in ectopic endometrial cells. As shown in some researches, elevated concentration of HGF both in peritoneal fluid and the ectopic endometrium was found in patients with endometriosis. But it remains controversial whether the expression of HGF in peritoneal fluid of endometriosis could vary with the stages of the disease. Furthermore, there were few researches about HGF in sera in patients with endometriosis. Therefore, the objective of the present study was to examine the in situ concentrations of HGF in peritoneal fluid and sera of women with and without endometriosis by ETISA and to investigate whether the level of HGF could vary with the stages of the disease. We expected to provide theoretical basis for novel therapy and monitoring indicators.Materials and methodsA total of 30 women between 20 and 40 years of age undergoing laparoscopy for benign conditions such as infertility or ovarian benign tumor in the Department of Obstetrics and Gynecology of the Second Affiliated Hospital in the Medical Uniwersity of China were included in this study. Diagnosis of endometriosis was established laparoscopically and histologically in 25 women. Samples of peritoneal fluid and sera were collected at the time of laparoscopy from 25 endometriosis patients and 10 women receiving laparoscopy for infertility or benign tumors in the ovary. According to revised American Fertility Society Classification ( 1985 ) , 9 of the 25 endometriosis patients were classified in stage I and II, and 16 in stage III and IV. All the women had normal menstrual cycles. The phase of menstrual cycle of the women was determined by. their last menstrual period. Ten were from non - endometriosis patients(follicular phase n = 6,luteal phase n =4) ,25 were from women with endometriosis (follicular phase n = 10, luteal phase n = 15 ) .Collection and processing of samples. The peritoneal fluid and sera were aspirated during laparoscpy and lapartomy. Immediately after collection, the samples were centrifuged at 3000 rpm for 10 minutes at 4 , and the superna-tants were aliquoted and stored at -80 until analyzed.HGF concentrations in the serum and PF wer...
|
PDF Full Text Request