Leukemia Inhibitory Factor And Protein Kinase B Play A Role In Endometrial Polyps

Objective: Endometrial polyp is one of the common endometrial lesions.The incidence rate is as high as25%. It is common in premenopausal andpostmenopausal women. The high risk factors are: age, late menopause,obesity, diabetes, tamoxifen therapy et al. At present, the diagnosis ofendometrial polyps mainly relies on the ultrasonic imaging and hysteroscopyexamination, and the prior treatment is resection under hysteroscopy. As theincidence of endometrial polyps is growing, the incidence of malignant changealso increase. The etiology research is becoming more and more important.There are many researches about the etiology of endometrial polyps, includinginflammation, hormone and its receptor, cytokine, the regulation of cellproliferation and apoptosis, and immune factors.Cytokines (cytokine) is a small molecule polypeptide mainly secreted byimmune cells, which regulate cell function. In the process of immune response,cytokines have important function to adjust the interactions between cells, cellgrowth and differentiation. There are variety of cytokines expressed in theendometrial tissue, such as the epidermal cell growth factor (EGF),insulin-like growth factor (IGF), vascular endothelial cell growth factor(VEGF) and so on. Their secretion and expression regulate the endometrialtissue lesions through specific endocrine pathway in endometrial tissue.Leukemia inhibitory factor (LIF) is a specific cell growth factor, playingan important role in the human reproductive and endocrine system. LIF canregulate cell proliferation, differentiation, phenotypic and inhibit the activityof lipoprotein lipase. Protein kinase B is also called the PKB, namely Akt, is aserine/threonine protein kinase, play an important role in cell survival andapoptosis. Insulin like growth factor (IGF) and survival factors can be activated Akt signaling pathways. LIF and Akt are proteins which hasrelationship with cell growth, cell proliferation and apoptosis. They areexpressed in many cells, and are close to a variety of benign and malignantdiseases. They affect and and they control the quantity and quality of cells,they play a crucial role in benign hyperplasic disease and malignant tumor.In our study，the content of LIF and Akt had been tested both in abnormaland normal groups. And combined with clinical data, the relationship of LIFand Akt was analysesed for the occurrence and development of endometrialpolyps, providing new ideas for clinical treatment and prevention of polyprecurrence.Methods:Using Western Blot method to detect the gray value represent theexpression of LIF and Akt in endometrial polyps and normal endometriumtissues. The differences between premenopausal and postmenopausal groupwere compared and the connections between the twofactors was explored.Results:1Clinical characteristics of endometrial polyps between premenopausaland postmenopausal women.The size of premenopausal and postmenopausal women was observed.The diameter of premenopausal polyp was1.43±0.55cm, and that of thepostmenopausal group was1.24±0.45cm, no significant difference accordingto the t test (P>0.05). The number polyps were different, single-shot14cases,multiple18cases in premenopausal group, while23single-shot23, multiple3cases in postmenopausal group. According to the chi-square test the differencewas statistically significant (P <0.05).2The epression of LIF, Akt in endometrial polyps and its relationshipwith clinical dataThe gray rates of LIF and Akt were1.317±0.210,1.147±0.175in theendometrial polyps group,0.929±0.202,0.812±0.184in normal endometriumtissues. Both LIF and Akt expression in endometrial polyps group were higher than those in normal endometrium tissues, the differences were statisticallysignificant according to the t test (P <0.05, P <0.05).The expression of LIF or Akt was found no difference betweenpremenopausal and postmenopausal endometrial polyps(P>0.05). To getaccurate data, single polyps were chosen to measure the diameter of the EP.In58patients with EP,37cases have one poly. They were separated by thediamerer of1.5cm, a group greater than and equal to1.5cm, and a groupless then1.5cm. The expression of LIF were1.204±0.140,1.405±0.210,andthe expression of Akt were1.079±0.130,1.218±0.18in two groups. Throughthe t test and nonparametric test, there were differences in the expression ofLIF and Akt, and the difference was statistically significant (P <0.05),showed that the larger the diameter of EP, the higher expression of LIFand Akt.3The correlation between LIF and AktAccording to Pearson correlation analysis, LIF and Akt correlationcoefficient r=0.772, and the correlation is statistically significant (P=0.011).Conclusion:1Premenopausal endometrial polyps are more likely to be multiple,single easily happen to postmenopausal women. Menopausal status hasnothing to do with the diameter of the endometrial polyps.2The occurrence of endometrial polyps is associated with LIF, itsexpression in polyp tissues is significantly higher than normal endometrialtissue. And there was no significant difference between premenopausal andpostmenopausal women who has endometrial polyps.3The LIF and Akt may be involved in the malignant transformationprocess of endometrial polyps.4The LIF/PI3K/Akt pathway may exist in the occurrence of endometrialpolyps.