The Influence Of Oral Tamoxifen On The Expression About Vascular Endothelial Growth Factor A, Angiopoietin2, Hypoxia In Ducible Factor-1 On Endometrium

Objective: To investigate the expression of vascular endothelial growth factor A(VEGF-A), angiopoietin2(ANG-2), hypoxia in ducible factor-1(HIF-1) on the endometrium about the one who took tamoxifen after breast cancer, and the influence on the endometrium. To understand the significance during the process endometrium canceration.Methods: Chosen the patients who took tamoxifen after breast cancer stochastic from March 2007 to March 2008, took the endometrium by hysteroscopy (comprise with cancer in situ, atypical hyperplasia, polypus hyperplasia), and the endometrium of cancerous,atypical hyperplasia endometrium , endometrial polyp (EMP) as control group. Expression of VEGF-A, ANG-2, HIF-1 on the endometrium about the one who took tamoxifen after breast cancer and the endometrium of cancerous, EMP proliferative endometrium by Immunohistochemistry, flow cytometry. Chosen the patients of breast cancer stochastic from June 2008 to December 2008 for adnexauteri sonography by vagina.According to the types of drug: Tamoxifen (TAM) , Letrozole (LET) , Non-drug (N-D) separated it to three groups; according to the condition about emmenia separated it to menostasia and emmenia two groups;according to the time with tamoxifen (T) separated it to T< 1year, 1year≤T<2year, T≥2year three groups. Recording the thickness of endometrium. To investigate the influence on endometrium about tamoxifen, and the relationship with different types of drug, the condition about emmenia, the time with tamoxifen.Result:1 Immunohistochemistry, flow cytometry both show that VEGF-A, ANG-2, HIF-1 all have express in the groups above. The masculine expression of VEGF-A is 43.2%, 75%, 50%, 76.7%, 43.3%, 16.7%, The masculine expression of ANG-2 is 45.5%, 25%, 50%, 76.7%, 50.0%, 20.0%. The masculine expression of HIF-1 is 40.9%, 25%, 50%, 90.0%, 53.3%, 13.3%. The high expression of VEGF-A, ANG-2, HIF-1 on the endometrium of cancerous, and significant difference of VEGF-A, ANG-2, HIF-1 expression was found between endometrium of cancerous and EMP proliferative endometrium in the group of non-drug, but there is no difference between any two of them in the group of drug.2 According to the adnexauteri sonography by vagina found: Both Tamoxifen (TAM) and Letrozole (LET) can induce the endometrium anomaly thicking, the incidence rate is 56.98%, 38.46%. Compared with the Non-drug (N-D) (12.90%) both have significant difference (P<0.05). But between the group of TAM and LET there is no significant difference (P>0.05). The incidence rate about the time with tamoxifen, less than one-year, one to two-year, over two-year is 38.36% (20/52), 45.83% (22/48), 77.78% (56/72), Compared with each other,between T< 1year and 1year≤T < 2year there is no significant difference(P>0.05). But compared with T≥2year above two groups both have significant difference (P<0.05). Whether exist menostasia there is no obviously influence on the endometrium.Conclusion:1 According to Immunohistochemistry and flow cytometry found that VEGF-A, ANG-2 ,HIF-1 all have expression in the group of polypus hyperplasia,atypical hyperplasia,cancer in situ, and the masculine expression to increase gradually along with the degree of malignant. They have close relation with endometrial cancer.2 In the group of polypus hyperplasia the masculine expression of VEGF-A, ANG-2 ,HIF-1 on endometrium with TAM is higher than the group of Non-drug.3 According to adnexauteri sonography by vagina found: the incidence rate of endometrium anomaly thicking will increase for the person who use Tamoxifen. And compare with the Non-drug there have significant difference (P<0.05). About the time with Tomaxifen over two years will made the incidence rate about the endometrium anomaly thicking highter than the group of the time with Tomaxifen less than two years (P<0.05). And whether menostasia there is no obviously influence to the endometrium (P>0.05).