The Expression And Significance Of Metalloproteinase-9 And Tissue Inhibitor Of Metalloproteinase-1 In Endometriosis

Endometriosis(EMs) is the ordinary disease of women. Retrograde menstruation represents a plausible explanation for the development of most cases of endometriosis, nevertherless, additional factors must contribute to the development of disease in only 10 to 20% of women. The implantation and invasive growth of endometriotic tissue is degradate extracellular matrix mechanisms. Matrix metalloproteinases(MMPs) are a family of endopeptidases which play a role in degradation and turnover of extracellular matrix proteins. Their action is regulated by specific tissue inhibitors called tissue inhibitors of metalloproteinase(TIMPs).In order to observe the expression of matrix metallo-proteinase-9(MMP-9) and tissue inhibitors of matrix metalloproteinase-1(TIMP-1) in the eutopic and ectopic endometrium of endometriosis to explore the correlation between the expression of MMP-9 and TIMP-1 in endometriosis to study the possible role of MMP-9 and TIMP-1 in endometriosis, we choose 68 women as subjects. The subjects were devided into two growps:38 patients(study group) with endometriosis or adenomyosis and 30 cases(control group) with hysteromyoma or dysfunctional uterine bleeding. Immunohistochemical method(S-P) was employed and the results were analyzed with SPSS 12.0 statistical software.The results of the study :①The positive rates of expression leveles of MMP-9 in the ectopic endometrium ,eutopic endometrium and normal endometrium are 73.6%,62.5% and 50.0%. The positive rate of the expression of the ectopic endometrium was significantly higher than those in the normal endometrium(P＜0.05)②The expression of TIMP-1 in the eutopic and ectopic endometrium of the patient with endometriosis was lower than that in the normal endometrium .There were no noticeable difference of the positive expression rates of TIMP-1 in endometriosis and normal endometrium.(P＞0.05)③There was significantly negative correlation between expressions of MMP-9 and TIMP-1 in normal endometrium. But there was no correlatation between the expression of MMP-9 and TIMP-1 in ectopic and eutopic endometrium of endometriosis.④There were no noticeable difference of the positive expression rates of MMP-9 and TIMP-1 in adenomyosis and other endometriosis(P＞0.05)⑤The expression of MMP-9 revealed phase-dependent changes in the glandular epithelia and stromal cells during the menstrualcycle in the control group. The expression rates of MMP-9 was higher in proliferative phase(60%) than those in secretory(30%) phase(P＜0.05).But there was no noticeable difference of positive expression rates of MMP-9 in endometriosis.(P＞0.05) From the study, we can draw conclusions:①Endometriotic tissue from women with endometriosis expressed significently lower levels of TIMP-1 than endometrium from normal women, and ectopic endometrium expressed higher levels of MMP-9 and a higher radio of MMP-9/TIMP-1 than eutopic endometrium from normal patients without endometriosis. These results suggest that MMP-9 may participate in the process of invasion and tissue remodeling that is hypothesized to occur in the pathogenesis of endometriosis, ectopic and eutopic endometrium from endometriosis patient may be more invasive and prone to peritoneal implantation . Thus, increased proteolytic activity may be one of the reasons for the invasive properties of the endometrium, resulting the development of endometriosis. ②There was no correlation between the occurrence of endometriosis and menstruacycle. The endometriums both in proliferstive phase and in secretory phase are invasive.