Studies Of The Expression Of Haptoglobin In Adenomyosis And The Relation With Algomenorrhea

Adenomyosis ,used to be called intrinsic endometriosis ,is a kind of benign lesioncharactering endometria l gla nds and stroma l invasion of the myometrium. The invasion of nonmyometriumis usua lly called extrinsic endometriosis .In recent years,it is found that there are alot of differences between intrinsic and external endometriosis . Therefore, it has been classifiedas an independent uterine disease . At home and abroad,it is reported that the incidence of thedisease is gradua lly increased and has become a common gynecological disease . To date,theexact etiology and pathogenesis of adenomyosis is not clear. At present, it ma inly involvesbasila r endometrium inva gination, the role of steroid hormones , immune factors , angiogenesis ,genetic factors and so on.The ma in performa nce of adenomyosis is the increased menstrual volume ,extendedmenstruation as well as dysmenorrhea and the dysmenorrhea gradua lly aggra vated.It is difficultto cure and seriously affect the physica l and mental health of women of childbearing age andreproductive function. One of them,pain is the most important clinica l ma nifestation. Includ ingdysmenorrhea , pelvic pain and intercourse pain. The incidence of dysmenorrhea l is as high as64.8% ~ 77.8%. It is reported that dysmenorrhea ma y be associa ted with steroid hormones ,oxytocin receptor, prostagla ndin, neura l med ia, and the scope of lesions in recent years. Atpresent,there are no effective conservative treatment methods .Drugs only alleviate symptomstemporarily and it has serious side effects in long-term use. Eventually we select hysterectomyin the treatment,which seriously affect the physica l and mental health of patients.It has found that the lesion tissue of people with adenomyosis can synthesize haptoglobin(Hp).Hp ma y interact with different immune cells ,then alter their sensitivity and stimula teangiogenesis .So the loca l positioning of HP in intra-abdomina l ma y change the immunefunction of lesions .,involve in angiogenesis, and then provide the blood supply for the growthof ectopic lesions . Ectopic lesions can produce considerable Hp and IL - 6,which make theectopic lesions evade the immune surveilla nce ,provide blood vessels for ectopic endometria land promote their growth. And it exist positive feedback between Hp and IL– 6.They jointlypromote the occurrence and development of adenomyosis .It is genera lly believed that there are specific relations between dysmenorrhea and PGincrease .Endometrium is the important part for PG synthesis . Much evidence shows that the increase of PG in uterus is an important reason for prima ry dysmenorrhea . And Hp is the ma inprotein for inhibiting PG. Because the expression of prostagla ndin and dysmenorrhea intensityis positively correla ted,we speculate the more haptoglobin synthesis ,the less prostagla ndinsynthesis ,the less obvious dysmenorrhea symptoms in patients.That is , expression ofhaptoglobin and intensity of dysmenorrhea is a nega tive correla tion . It has been proved to beeffective in clinica l for NSAIDs in the treatment of dysmenorrhea l,the mecha nism of which isto reduce the produce of PGs.This experiment uses immunohistochemistry method to test the expression of Haptoglobin(Hp) in the study group (including the eutopic endometrium and ectopia lesions respectively 18cases) and the control group (including the norma l endometrium and muscular la yerrespectively 18 cases). There was no significa nt difference in age for all subjects .We useconcise statistica l software 10.32 to conduct statistica l analysis of data, use t tests to conductstatistica l treatment,and think there is statistica l significa nce when the p value is less tha n 0.05.Found in this experiment:Hp at AM eutopic endometrium and ectopia lesions weresignifica ntly higher tha n that in norma l eutopic endometrium and muscular la yer.It shows thatthe incidence of adenomyosis is strength-related with the expression of Hp in endometrium andlesions . We also found that the expression of Hp in the follicular phase was less tha n lutealphase for Hp expression in eutopic endometrium of AM patients,but no significa nt difference;but in AM patient ectopia lesions , Hp expression in follicular phase was more tha n the lutealphase, and p <0.05, the difference had statistica l significa nce.There is no cyclica l HPexpression at AM eutopic endometrium.But Hp in the ectopia lesions had shown signs ofcyclica l changes in follicular phase more tha n luteal phase ,and in luteal phase eutopicendometrium expression was significa ntly larger tha n ectopia lesions . The results showed that:Hp expression at eutopic endometrium in the non dysmenorrhea group is greater tha nDysmenorrhea group, but no significa nt difference; Hp expression at ectopia lesions in thedysmenorrhea group is less tha n non-Dysmenorrhea group, p <0.05, and difference hasstatistica l significa nce , that is,dysmenorrhea of patients with adenomyosis is ma inly related tostrong and weak expression of Hp in ectopia lesions , but has nothing to do with Hp strength ineutopic endometrium. At the same time we also found that Hp expression at eutopicendometrium was gradua lly decreasing with the pain aggra vating in the overa ll trend ,although the non dysmenorrhea to mild dysmenorrhea group and moderate to severedysmenorrhea group Hp expression slightly increased ,p>0.05,no significa nt difference; and thenon dysmenorrhea to the light, moderate and severe dysmenorrhea group, compared to each other ,all p> 0.05, no significa nt difference . And Hp expression at ectopia lesions was alsogradua lly decreasing with the pain aggra vating in the overa ll trend , although the expressiondegree of moderate to severe dysmenorrhea increased , p> 0.05, no significa nt difference;however not like the expression at eutopic endometrium,the difference is in the ectopia lesionsfrom non dysmenorrhea group to the mild , moderate, severe dysmenorrhea group, compared toeach other, all p<0.05, and differences were mea ning, significa ntly better able to expla in themajor relationship between dysmenorrhea and the strength of Hp expression at ectopia lesionsof adenomyosis patients. We also concluded that dysmenorrhea degree and strength of Hpexpression was nega tively correla ted,which was consistent with previous speculation. WithHaptoglobin in-depth research at the pathogenesis of adenomyosis and its relationship withdysmenorrhea ,to regulate and control the expression of haptoglobin probably becomes a newway to treatment and prevention of the disease . In short, Haptoglobin as a glycoprotein ofadenomyosis patient synthesis and secretion by eutopic endometrium cells and ectopicendometrium tissue , has been involved in the certain aspect of adenomyosis pathogenesis, andcan ease the symptoms of dysmenorrhea by inhibiting the synthesis of prostagla ndin. Of theHaptoglobin-depth study will help to further understa nd adenomyosis pathogenesis and itsrelationship with dysmenorrhea, which has opened a new line of thought for adenomyosis noninvasivedia gnosis and immunological treatment.This experiment comes up with the following conclusions:1,Haptoglobin (Hp) expression in adenomyosis eutopic endometrium and ectopialesions showed high,which showed that the expression strength of Hp in adenomyosis eutopicendometrium and ectopia lesions ma y be related to the occurrence and development of thedisease .2,Hp expression in adenomyosis ectopia lesions has cyclica l changes in follicular phasemore tha n the luteal phase, but Hp expression at eutopic endometrium in non-cyclica l changes.3,Dysmenorrhea in adenomyosis patients has nothing to do with Hp expression at eutopicendometrium,but ma inly with the strength of Hp expression at ectopia lesions , and they werenega tively correla ted.