Study On Expression And Significance Of Estrogen Receptor Isoforms And Active Protein-1 In Adenomyosis

Objective:To investigate the expression and clinical significance of estrogen receptor isoforms and active protein-1 in adenomyosis.Methods:1.A total of 40 cases of adenomyosis with their corresponding ectopic endometrium and eutopic endometrium (22 cases of proliferation phase and 18 cases of secretary phase) and 30 cases of normal endometrium(17 cases of proliferation phase and 13 cases of secretary phase) were included. The routine two-steps immunohistochemical method was used to measure the expressions of ERα,ERβand c-jun(the part of AP-1) .2.A total of 20 cases of adenomyosis with their corresponding ectopic endometrium and eutopic endometrium (10 cases of proliferation phase and 10 cases of secretary phase) and 20 cases of normal endometrium(10 cases of proliferation phase and 10 cases of secretary phase) were included. The Western-blot method was used to measure the expressions of ERα,ERβand c-jun(the part of AP-1) .These cases were selected correspondingly from the above cases(Method 1).Results:1. The results of immunohistochemical method(1) Ectopic endometrium group VS normal endometrium group: the expression of ERβand c-jun [histochemistry score(H-SCORE): (3.4080±0.2095),(3.2040±0.3195)] were significantly higher than those in normal endometrium group[H-Score:(2.7863±0.1478),(2.5700±0.1695),both P<0.01],the expression of ERα[H-Score:(3.4120±0.2766)]and the ratio of ERα/ ERβ(1.0016±0.0603)were significantly lower than those in normal endometrium group[H-Score(:3.7238±0.1628), the ratio of ERα/ ERβ:(1.3411±0.0824),both P<0.01].(2) Eutopic endometrium group VS normal endometrium group: the expression of ERβand c-jun [H-Score:(3.3943±0.1976),(3.1775±0.3090)]were significantly higher than those in normal endometrium group[H-Score: ( 2.7863±0.1478 ) ,(2.5700±0.1695),both P<0.01],the expression of ERα[H-Score:(3.4258±0.2551)]and the ratio of ERα/ ERβ(1.0097±0.0570)were significantly lower than those in normal endometrium group[H-Score:(3.7238±0.1628), the ratio of ERα/ERβ:(1.3411±0.0824),both P<0.01].(3)Ectopic endometrium group VS eutopic endometrium group: the significant difference was not seen between those group on the expression of ERα, ERβ, c-jun and the ratio of ERα/ ERβ(P=0.512, 0.403, 0.570, 0.348). (4) The correlation between the ratio ERα/ ERβand the expression of c-jun: the ratio ERα/ ERβand the expression of c-jun had negative correlation in ectopic endometrium group and eutopic endometrium group(r =-0.683, -0.692, both P<0.01), but on significant correlation in normal endometrium group (r =-0.170, P=0.369).2. The results of Western-blot method(1) Ectopic endometrium group VS normal endometrium group: the expression of ERβand c-jun [Integrated option density(IOD)(:529.5720±5.5412)(,518.5390±13.7481)]were significantly higher than those in normal endometrium group[IOD:(352.6030±31.3287),( 360.0030±9.5776),both P<0.01],the expression of ERα[IOD:(535.2980±8.4447)]and the ratio of ERα/ ERβ(1.0109±0.0176)were significantly lower than those in normal endometrium group[IOD(:751.2165±31.9425), the ratio of ERα/ ERβ:(2.1392±0.1071),both P<0.01].(2) Eutopic endometrium group VS normal endometrium group: the expression of ERβand c-jun [IOD(:528.3865±4.4195)(,515.9735±11.2767)]were significantly higher than those in normal endometrium group[IOD: ( 352.6030±31.3287 ) ,(360.0030±9.5776),both P<0.01],the expression of ERα[IOD(:534.2340±10.0341)]and the ratio of ERα/ ERβ(1.0125±0.0171)were significantly lower than those in normal endometrium group[IOD:(751.2165±31.9425), the ratio of ERα/ ERβ(2.1392±0.1071),both P<0.01].(3)Ectopic endometrium group VS eutopic endometrium group: the significant difference was not seen between those group on the expression of ERα, ERβ, c-jun and the ratio of ERα/ ERβ(P=0.175,0.056,0.068,0.676).(4) The correlation between the ratio ERα/ ERβand the expression of c-jun: the ratio ERα/ ERβand the expression of c-jun had negative correlation in ectopic endometrium group and eutopic endometrium group(r =-0.725, -0.679, both P<0.01), but on significant correlation in normal endometrium group (r =-0.258, p=0.273).Conclusions:1. Compared whit those in normal endometrium ,the ratio ERα/ERβreduced, ERβexpressed predominantly,whereas the expression of ERαis limited in ectopic endometrium and eutopic endometrium of patients with adenomyosis.ERβmay be essential for the development and growth of adenomyosis.2. Compared whit those in normal endometrium, AP-1 expressed ascendingly in ectopic endometrium and eutopic endometrium of patients with adenomyosis.AP-1 may play an important role in the development of adenomyosis. 3. Compared whit those in normal endometrium, the ratio ERα/ ERβand the expression of c-jun had negative correlation in ectopic endometrium group and eutopic endometrium group. ERβmay be essential for activating protein-1 signaling pathways.