The Comparison Study On Expression Of KGF, Survivin Protein In The Various Kinds Of Endometriosis

Objective:To investigate the expression and the relationship of KGF (keratinocyte growth factor) , survivin proteins and apoptosis cells in the normal endometrium, adenomyosis and the ovary endometriosis, and to studay the relationship among the three index and the volume of adenomyosis, staging and the diameter of the cysts of the ovary endometriosis. To study the pathological mechanisms of adenomyosis and the ovary endometriosis to help clinical themaphy.Methods: A total of 114 tissues samples were used in this study, including 40 patients with histologically proven adenomyosis( 24 in the proliferative phase and 16 in the secretive phase) and 34 patients with histologically proven the ovary endometriosis(26 in the proliferative phase and 8 in the secretive phase) and 40 samples of normal endomtrium tissues(26 in the proliferative phase and 14 in the secretive phase). Using the method of immunohistochemistry, we examined the expression of survivin and KGF proteins in the glandular and stromal cells of the eutopic and ectopic endometrium of adenomyosis and the ovary endometriosis and the normal endometrium. By HE stain sections we number apoptosis cells of above tissues. We study the difference of the three index of the different cells and different menutrual phase (the normal, eutopic and ectopic endometrium;the glandular and stomal cells;proliferative and secretive phase). The clinical materials of AM and OEMs was summarized. The relationship among KGF, survivin proteins and apoptosis cells were studied. The relationship between the three index(KGF, survivin protein and apoptosis cells) and the volume of adenomyosis, staging of OEMs and the diameter of the cysts of OEMs was studied.Result: 1.KGF protein(1) KGF proteins most expressed in the stromal cells. The glandular cells of the normal endometrium stained significantly higher in proliferative phase than in secretary phase, whereas there were no cyclic changes in AM and OEMs.(2) In adenomyosis, KGF protein in the stromal cells of the eutopic and the ectopic endometrium was higher than the stromal cells of the normal endometrium. The same result found in the glandular cells(p<0.017). The glandular and stromalcells of the eutopic endometrium expressed higher KGF protein than that of ectopic endometrium(p < 0.017).(3)In the ovary endometriosis, KGF protein in the stromal cells of the eutopic and the ectopic endometrium was higher than the stromal cells of the normal endometrium(p<0.017). There was no significant differences between the stromal cells of the eutopic and ectopic endometrium of OEMs(p > 0.017). The glandular cells of the eutopic and ectopic endometrium of OEMs expressed higher KGF protein than the normal endometrium (p<0.017), and there was no significant differences between the glanduar cells of the eutopic and ectopic endometrium of OEMs(p> 0.017).(4)Comparing adenomyosis with the ovary endometriosis, in the case of the glandular and stromal cells of the eutopic and ectopic endometrium of AM, the expression of KGF protein was higher than OEMs (p<0.017).2. Survivin protein(1) Survivin protein expressed mainly in the glandular cells, the menstrual phase had no influence on survivin protein in the endometrium of the controls and the eutopic and ectopic endometrium of AM and OEMs.(2)In adenomyosis, the glandular cells of the eutopic and ectopic endometrium of AM expressed higher survivin protein than the glandular cells of the normal endometrium(p<0.017), and the glandular cells of the ectopic endometrium of AM expressed higher survivin protein than the eutopic(p<0.017). In the case of the stromal cells, there were no significant differences between AM and the normal endometrium.(3)In ovary endometriosis, the glandular cells of the ectopic endometrium expressed higher survivin protein than the eutopic(p<0.017), whereas there were no significant differences between the glandular cells of the eutopic and normal endometrium(p > 0.017).(4) Comparing adenomyosis with the ovary endometriosis, the glandular cells of the eutopic and ectopic endometrium of AM expressed survivin higher than the eutopic and ectopic endometrium of OEMs's.3. Apoptosis cells(1) The apoptosis cells mainly located in the stromal cells (P<0.05),and all no cyclic changes.(2) In adenomyosis, the number of apoptosis cells in the glandular and stomal cells of the eutopic and ectopic endometrium of AM were lower than the glandular and stomal cells of the normal endometrium, and the number of apoptosis cells in the glandular and stomal cells of the ectopic endometrium of AM were lower than the eutopic endometrium.(3) In ovary endometriosis, there was no significant difference in the glandular cells of the eutopic and ectopic endometrium of OEMs(p<0.017), but they all expressed lower apoptosis cells than the normal endometrium(p<0.017). The number of apoptosis cells of the stromal cells of the ectopic and eutopic endometrium of OEMs were lower than the normal stromal cells(p<0.017), and the number of apoptosis cells of the stromal cells of the ectopic endometrium of OEMs were lower than the eutopic stromal cells of OEMs.(4) Comparing adenomyosis with the ovary endometriosis, the number of apoptosis cells of the glandular cells of the eutopic and ectopic endometrium of AM were lower than OEMs's, respectively. The same result found in the stromal cells of the eutopic and ectopic endometrium of OEMs.4.There were negative correlation between survivin protein and apoptosis cells in the eutopic endometrium of AM,and the same result was found in the ectopic endometrium of AM.5.There were no correlation between the three index(KGF, survivin protein and apoptosis cells) and the volume of AM, the staging of OEMs, the diameter of the cysts of OEMs. Conclusions:1 .In adenomyosis and the ovary endometriosis, the stromal cells of the eutopic and ectopic endometrium expressed higher KGF protein than the normal controls, and KGF induces cell proliferation by paracrine and antocrine. The glandular cells of the eutopic and ectopic endometrium of AM and OEMs stained deeper than thenormal, and KGF induces the glanduar cells proliferation by paracrine. And these may inhance the metastasis ability of endometrium and lead to the onset of this disease.2. Survivin protein mainly expressed in the glanduar cells. The overexpression of survivin protein and survivin-collected apoptosis may play pathogenic roles in the development of the ovary endometriosis and adenomyosis.3. Comparing AM with OEMs, the expression of KGF, Survivin protein and apoptosis cells was different. The capability of prolifiration and anti-apoptosis of AM was higher than OEMs, so it was thought that the pathological mechanism of AM and OEMs was different. But the character of the eutopic and the stromal cells of the eutopic was probably identical, so it was supposed that they were the different results in different parts and envioments of the same etiopathogenisis.4. The capability of prolifiration anti-apoptosis of the stromal cells may play pathogenic roles in the development of endometriosis and adenomyosis. The eutopic stromal cells may be the internal cause of AM of OEMs.5.There was difference in the proliferation and anti-apoptosis capability beweeen the eutopic and normal endometrium. The difference between the eutopic endometrium and the normal endometrium affeted the happening and developing of AM and OEMs.