Immunohistochemistry Study Of Collagen Type Ⅰ And Ⅲ In Adenomyosis

Adenomyosis refers to endometrial glands and stroma locatedhaphazardly deep within the myometrium.Multiparas,generally afterage 40,were most commonly affected it . As a benign lesion it had abiological behaviour of invasive growth and the behabiour wassimilar with malignant tumour . The diagnosis was difficult and theaccuracy rating of preoperative diagnosis was only 15 per cent . Themost effective therapy was hysterectomy,but hysterectomy wouldhave a bad effect on the physical and mental health . The incidenceof adenomyosis was increasing in recent years . But the exactaetiology and pathogenic mechanisms of adenomyosis are stillpoorly understood . Therefore , to explore the radical reason and toseek the effective diagnosis and therapy appear mostly important .In adenomyosis focus we find a great deal of interstitialcollagen . Abnormal deposite of interstitial collagen was thecharacteristic of fibrosis disease . Collagen typeⅠand Ⅲ showedhigh expression in various kinds fibrosis disease which hadimportant effects on the development of fibrosis disease . Thecontents of collagen type Ⅰand Ⅲ were the maximum in humanbody and they were the predominant collagen in uterus tissue . Theobjective of our study is to explore the role of collagen type ⅠandⅢ in the pathogenesy of adenomyosis.Now foreign literature hadalready report the distribution and contents on collagen type Ⅲ ineutopic and ectopic endometrium,but domestic reports had not foundcorrelated research .The present study included 30 patients. The were treated byhysterectomy from January 2004 to December 2005 at thedepartment of Obstetrics and Gynecology in the second ClinicalHospital of Jilin University,pathologically proved 15 cases ofadenomyosis(Adenomyosis Group)and 15 cases of nomal uterus(Normal Group). All patients in our study had not used anyhormonal contraceptive medicine or devices three months beforeoperation.And it is no difference between the pregnant and surgeryhistory among the patients. Immunohistochemical staining forcollagen type Ⅰand Ⅲ were performed by SP . The stainingintensity was semiquantitative determined ( gray scale ) withHPIAS-1000 color imaging analysis system . The consequence wasexpressed with ±s. SPSS statistical software was used forstatistical analysis.The significance of difference between individualgroups was assessed with t-test,q-test and so on .In our study,the expression of collagen typeⅠwas muchstronger in adenomyosis myometrium than in nomal myometrium(P<0.05). Collagen type Ⅰaccounted for approximately 90 percent of total collagenous tissue in human body and it was thepredominant collagen in uterus . Furthermore the stronger staining ofcollagen type I was found at the periphery of deep ectopic implants .The study suggested that collagen type I was the predominantcollagen present in the surrounding collagenous tissue associatedwith deep,ectopic endometrial implants . And collagen type Imaybe closely correlated with the development of adenomyosis .Collagen with the specific construction,biologic properties andphysiologic function can promote the biology behavior of ectopicendometrium , such as adhere , migrate , proliferation ,celldifferentiation and apoptosis . And the adhesion of collagen andendometrial stromal cells could up-regulate Fas ligand (FasL)expression,which could induce apoptosis of activated T lymphocytesand conduce immune tolerance of ectopic endometrium,promotefurther development of ectopic implants .In the present study,we also find the contents of collagen typeⅠobviously accrescence in both ectopic endometrium and eutopicendometrium compared with nomal endometrium(P<0.05). And thecontents of collagen type Ⅰwere no distinction between ectopic andeutopic endometrium(P>0.05). To clarify the mechanism of theorigin of adenomyosis, Ikegami A investigated theimmunohistochemical distribution of collagen type III in the humanendometrium and the adenomyosis throughout the menstrual cycle .The intensity of staining of collagen type III in ectopic endometriumparalleled that in eutopic endometrium . It is conformity with ourstudy . In the study of fibrosis,we found that Collagen typeⅠandⅢ had important effects on the development of fibrosis disease. Inhepatic fibrosis,collagen typeⅠwas the main type of abnomalexpression and it was three times more than collagen type Ⅲ . Inpulmonary fibrosis,the rate of collagen type Ⅰand Ⅲ increasedfrom 2:1 to 3～4:1. In the present study,we find the gray scale rateof collagen type Ⅰand Ⅲ changes from 0.9996(Nomal Group)to0.8877(Adenomyosis Group). It is similar with the description offibrosis disease .Conclusively , the expression of collagen type Ⅰ hassignificant distinction between eutopic endometrium and normalendometrium,but there is no difference between eutopic and ectopicendometrium . It suggest that the occurrence of adenomyosis hadintimate correlation with heredity . Thus,the genetic differencebetween eutopic endometrium and normal endometrium determinethe ectopic implants of endometrium . Whereas the abnomalexpression of collagen type Ⅲ has no correlation withadenomyosis .