| Endometriosis is a common gynecologic disease, whichseriously impacts patients'life. It generally follows a benigncourse,but it has some characters like cancer. Nowadays there is ahigh frequency of endometriosis.Now the pathogenesis is unknown.Recent molecular studys show that it has relation with the presenceof oncogenes and the tumor suppressor genetic mutation. PTEN(thetumor suppressor gene phosphate and tensin homolog) is the secondhighest mutation incidence after p53 in human cancer ,which is thefirst tumor suppressor with phosphatase activity. The absentexpression and mutation of PTEN has special significance in diversetype of diseases relevant to endometrium. In order to explorewhether PTEN is involved in the origenesis and progression ofendometriosis and menstrual cycle ,we evaluated the PTEN ineutopic and ectopic endometrium obtained from endometriosis andnormal endometrium.The subjects were selected in the China-Japan Union hospital ofJilin University between april in 2004-october in 2005.Patients withendometriosis with a mean age of 44.5(range 33-48) include 30 withendometrial cyst of the ovary and 15 with adenomyosis . Ectopic andeutopic endometrial tissues were obtained (21 in the proliferativephase and 24 in the secretory phase).In endometrial cyst ofovary ,10,7,7and 6 of the cases were respectively classified as torepaired AFS stage â… ,â…¡,â…¢,â…£.40 normal endometrium wereselected through endometrial curettage from volunteers withoutgynecologic diseases at the same time.Patients with mean age42(range 28-49)include 14 in the proliferative phase and 26 in thesecretory phase.All patients had not received either chemotherapy orradiation therapy before surgery. All tissues were fixed in 10%buffered formaldehyle and prossed into routinely paraffin-embeddedblocks,cutted for five-micrometer sections. For each samples,threesects were needed,one for stained with HE to patho-diagnosis,one fornegative contrast,one for immunohistochemist. The sections werestained immunohistochemically , stained with diaminobenzidine(DAB) and counterstained with haematoxylin.Procedures wasinstructed by directions of agent.Observed by lower power lens,Thecells which show brown-yellow at cell plasma were positive. Theresult was defined as-,1+,2+,3+ when the rate of positived cells insame cells was none ,<1/3,1/3-2/3,>2/3.Result:1 There was no difference in age from all groups. Age as amixed factor was excluded.2 The expression of PTEN was found at epithelial cellplasma ,little was at interstitial cells.The positive cells which showbrown-yellow distributed dispersively or locally.The expression ofPTEN in ectopic endometrium was significantly decreased ,whichshows decreased cell number or even without staining.PTEN innormal endometrium showed high expression,but the expression ofPTEN in eutopic endometrium was between normal and ectopicendometrium.In ectopic endometrium the positive expression ofPTEN in proliferative phase was 33.3%,50.0% in secretoryphase.There was no difference between them(p>0.05).3 The positive expression of PTEN in endometrial cyst of ovarywas 46.7%, 33.3% in adenomyosis.There was no difference(p>0.05).4 The positive expression of PTEN in endometriosis ofâ… -â…¡stage was significantly higher than of â…¢-â…£(p<0.05).5 The expression of PTEN showed stronger positive or positivein normal endometrium. Moreover the expression varied bymenstrual cycle.Expression of PTEN in proliferative endometriumwas significantly lower than in secretory phase.Conclusion:1 The expression of PTEN in ectopic endometrium was lowerthan either eutopic or normal endometrium. Moreover the expressionin ectopic endometrium did not vary by menstrual cycle. Deletion ofPTEN is one of the pathogenesis of endometriosis.2 The expression of PTEN in eutopic endometrium wasbetween in ectopic and normal endomerium.Eutopic endometriumhas diffenent characters from normal endometrium.This proves "thetheory of eutopic endometrium determination". Evaluating PTEN ismaybe a new idea to forecast and diagnosis endometriosis in eutopicendometrium.3 The expression of PTEN was no difference between inendometrial cyst of ovary and in adenomyosis .4 The expression of PTEN was associated with clinicalstage,the later clinical stage of endometriosis,the fewer theexpression of PTEN.Deletion of PTEN possibly involvesprogression and malignant transformation of endometriosis.Evaluating PTEN is possibly a useful index to diagnosis earlymalignant transformation of endometriosis and to infer it'sprognosis.5 The expression of PTEN in normal endometrium washigh.The expression in proliferative phase was markedly lower thanin secretory phase.PTEN maybe regulates the menstrual cycle.The origin and progression of endometriosis is cooperatedwith many factors and many steps, such as genemutation,immunology changing,physiological and biochemicalchanging.In this study ,we prove the tumor suppressor PTEN isdeleted in endometriosis,PTEN involves the origin and progressionof endometriosis.This not only helps to make the pathogenesis ofendometriosis clear,but also provides a new ideology for diagnosisand therapy of endometriosis.At present many scholars havegenerally study the transfection of PTEN into tumor which caninhibit growth of tumor ,and they have achieved some .But nowthere are no report about in human,which need more study.
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