The Risk Factors And Expression Of VEGF And MVD In The Endometrium Of AM Patients With IUD

Adenomyosis (AM) generally means that endometrium (inclu-deing gland and mesenchyma) invade uterus muscle, which diffusesin uterus muscle, because adenomyosis is similar with endometrium,so adenomysis is also called internal endometrium. Much differenceis found between adenomyosis and eddometrium recently, so peopletend to treate it as an individual disease. Adenomyosis is one ofcommon encountered diseases for married women and recognized byhuman being increasingly, the incidence rate of both AM and EM isincreasing too. But the report of study the AM pathogenetic causes isscarce. When comes to IUD, whether it is risk to induce AM is stilldisputable. China used more IUD than other country in the world, asa result, it is very important to study the relationship between AMand IUD in china. Up till now, the most report concerning AM isonly about the retro-spective analysis, a few is forward lookingreport, no molecule level study to confirm. The manifestations ofVEGF and MVD reflects forming of rebirth blood vessel which hasclose relationship with the disease, so to research the manifestationsof VEGF and MVD in eutopic endometrium and ectopicendometrium, for patient with IUD and being diagnosed AM, maybeexplore new target and provide theory basis for making sure therisky factor of AM.Objective: the test aims to detect the vascular endothelialgrowth fator (VEGF) and microvessel density (MVD) in eutopicendometrium and ectopic endometrium of two groups AM patients,one group with IUD and the other group without IUD, accomp-anying with the clinical information, to find the relationship amongthe VEGF, MVD, IUD application and AM, to confirm IUD is a riskfactor of AM and seek new target and provide with theoretical basis.Methods: the research sample are patients who underwentsupracervical hysterectomy or total hysterectomy in ChangchunCenter hospital from January to October of 2005, and select 88 caseswhich diagnosed AM, excluding the patient who come to hospitalsecondly because of AM and who had both AM and uterine myoma,select random 141 cases who diagnosed uterine myoma as comp-aring group, all selected women above are married and live inChangchun city aged 43.5±6.32 and 43.8±5.99 years, select the AMgroup according to following condition strictly: normal delivery onlyone time without any uterine cavity operation and taking anyhormonic drug and without endocrine disease, 10 cases with O-shapeIUD aged 42.5±5.42 years. To carry out rectro spective analysis andadopt immuhistochemistry methods to measure the VEGF and MVDchanges in eutopic endometrium and ectopic endometrium of twogroups. VEGF mainly locate in galndular epithelium and stormacell, its organism is very clear under microscope, the tan particulatewas found in kytoplasm of glandular epithela, furthemore the stainedcolor was deeper then other positive cell. To carry out half-quan-titative measurement according to immuhistochemistry rating systemand number of positive cell, each histologic section rate from 1 to 8score. MVD stained with CD34, the staining endotheliocyte color istan. To search dense area of microvessel under low power micros-cope, then counting under 5 different field of powerfull microscope,the mean value is consider as the result, the unit is pieces/400 X field,single endothelial or its clustering were counted as one microvessel,whether microvessel tube is found or there was endotheliocyte wasfound in microvessel was not the counting criteria, but exclude oneshad lager microvessel and thicker myometrium or more than 8endothelioytes was found in microvessel. The SARS statisticalsoftware was used for statistical analysis, χ2 –test and Wilconxon isused for measurement data, to adopt t-test and linear correlation forcount data, stepwise regreeion was used for multiple analysis.Result: analysis from clinical information shows difference forpatients' age and weight was not significant between two groups(p>0.05), it is slightly different for catamenia menarche age betweentwo groups. The discrepancie between two groups of idiopathydysmenorrheal is significant (p>0.05). Incidence rate for patientswho suffered pregnancy, delivery and abortion before differedsignificantly, there is similitude (p>0.10), between compositionratios of two groups of patients with pregnant, delivery and inducedabortion times of 0, 1 or 2. The pregnancy times of married patientstend to decrease in AM group. The factor with significant relation toAM is induced abortion experience and times of delivery, whichcome from the result of AM multiple analysis. Immuhistochemistryanalysis shows that manifestations of VEGF and MVD can be foundin both eutopic endometrium and ectopic endometrium of AMpatient, more found in ectopic endometrium (p<0.05), manifestationsof VEGF and MVD can be found more in endometrium of AMpatient with IUD inserted than without IUD (p<0.05), with theincreasing of manifestations of VEGF and MVD in eutopicendometrium, manifestations of VEGF and in ectopic endometriumchanges correspondingly (p<0.05).Conclusions: the induced abortion is a risky factor to induceAM. The delivery times is the protective factors for AM. The AM'sectopic endometrium cells has more invasive ability.