The Expression And Significance Of Matrix Metalloproteinase-9 And Tissue Inhibitor Of Metalloproteinase-3 In Ectopic And Eutopic Endometrium In Women With Endometriosis

Objective: To study the gene expression of matrix metalloproteinase-9(MMP-9) and tissue inhibitor of matrix metalloproteinase-3(TIMP-3)in the endometriotic lesions and endometrium from women with and without endometriosis and to explore their possible roles in the pathogenesis of endometriosis(EMs).Methods : specimens of 39 endometriosis patients including 22 specimens of eutopic endometrium, 16 specimens of red peritoneal lesions, 35 specimens of ovarian endometrioma were collected . specimens of endometrium of 28 patients with leiomyoma were collected during operation and used as controls . Reverse transcription-polymerase chain reaction(RT-PCR) was employed to detect the gene expression of MMP-9 andTIMP-3 in different tissues.Results : 1.The expression of MMP-9 mRNA and the ratio of MMP-9/TIMP-3 mRNA in red peritoneal lesions were significantly higher than those in endometrium from patients without endometriosis (P<0.01, P<0.01) , and the expression of TIMP-3 mRNA in two groups were not different;The expression of MMP-9 mRNA in ovarian chocolate cysts were not different from endometrium without endometriosis, but the TIMP-3 mRNA in the former group is significantly higher than latter (P<0.05 );The expression of MMP-9 mRNA in red peritoneal lesions were significantly higher than those in ovarian chocolate cyst (P<0.01) and the expression of TIMP-3 mRNA in former is lower than latter (P<0.05), which results to the higher ratio of MMP-9/TIMP-3 mRNA in former (P<0.01). 2. The expression of MMP-9 mRNA and the ratio of MMP-9/TIMP-3 mRNA in endometrium with endometriosis were significantly higher than those in endometrium from patients without endometriosis(P<0.05). 3. The expression of MMP-9 mRNA in red peritoneal lesions were significantly higher than those in endometrium with endometriosis, and the expression of TIMP-3 mRNA in tow groups were similar, which result to the ratio of MMP-9/TIMP-3 mRNA in former is higher than the latter. 4. Extracts of endometrium from endometriosis and controls both showed significantly higher levels of MMP-9 mRNA and lower levels of TIMP-3 mRNA in proliferative phase than in secretory phase(P<0.05),which were all relevant to the menstrual cycles, but those in endometriotic lesions were not.Conclusions: 1. The expression of MMP-9 and the ratio of MMP-9/TIMP-3 mRNA in red peritoneal lesions is higher than those in normal endometrium and ovarian chocolate cyst, which show MMP-9 andTIMP-3 were related with activeness of the lesions and the earlylesion has more invasiveness and implantation. 2. The expression of MMP-9 and the ratio of MMP-9/TIMP-3 mRNA in eutopic endometrium with endometriosis is higher than those in normal endometrium, which show endometrium with endometriosis was different from normal endometrium, the endometrium with endometriosis is more invasive than nomal endometrium. 3. The expression of MMP-9 and TIMP-3 in the ectopic tissues with endometriosis were not relevant to the menstrual cycles.Postgraduate studentrjing Gao (Obstetrics and Gynecology) Directed by prof. Xin-hua Guo...