The Expression And Significance Of P63,P450arom And SF-1in Endometrial Polyps (Attaching The Clinical Analysis Of200Cases Of Endometrial Polyps)

In recent years, with the improvement of living standards and the participation in the healthy physical examination and use of hormone replacement therapy has been growing steadily, the incidence of endometrial polyps(EP) has significantly increased. Endometrial polyps has been given more and more concern. EP is a common intrauterine benign lesions, its clinical manifestation can be abnormal vaginal bleeding, also may be asymptomatic.It is often mixed with endometrial hyperplasia or endometrial precancerous lesions. According to reports, confirmed by hysteroscopy in all abnormal uterine bleeding in women, abnormal bleeding caused by endometrial polyps accounted for about30%[1]. However, the pathogenesis of endometrial polyps is not clear. There is no clear and effective drug in the clinical treatment measures, the main treatment for hysteroscopic polypectomy. The using of Mirena after Hysteroscopic polypectomy to prevent polyp recurrence has been noticed, but it lacks of adequate basic research [2].The study is divided into two parts:1) The basic research in the pathogenesis of endometrial polyps (the role and significance of aromatase cytochrome P450, SF-1and P63);2) Clinical analysis of200cases of Endometrial Polyps.Part Ⅰ. The basic research on the pathogenesis of endometrial polyps (the role and significance of aromatase cytochrome P450,SF-1and P63)[Objective] Through the study of aromatase cytochrome P450(P450arom), steroidogenic factor-1(SF-1) in endometrial polyps, we aimed to investigate the relationship between endometrial polyps and estrogen. Then we can provide ideas and theoretical basis for the clinical application of drug therapy of endometrial polyps. Research on stem cell surface markers P63expression in endometrial polyps can help us to explore the source of polyps preliminary exploration.[Methods] Specimen were collected from hysteroscopic resection, pathologically confirmed endometrial polyps specimens of30cases of endometrial polyps and the adjoining endometrium around endometrial polyps in20cases, endometrial tissue of normal control group of25patients (including the proliferation of16cases, secretion9cases). Immunohistochemistry SP method and Real-time PCR technology were used to detect the three groups in the expression of p63,P450arom and SF-1protein and gene. SPSS data analysis software was adopted for the data processing and correlation analysis of the expression of the three indicators.[Results] P450arom gene and protein expression in endometrial polyps was significantly higher than the adjoining endometrium and normal endometrium (p<0.05); the expression of SF-1and p63protein were also higher in the endometrial polyps than the other two control groups; the expression of SF-1mRNA and P63mRNA in endometrial polyps had no significant difference between endometrial polyps and the surrounding adjacent endometrial; there has no expression of mRNA and protein in these three indicators in the normal endometrium.[Conclusion] The overexpression of aromatase cytochrome P450and steroidogenic factor-1in EP suggest that the pathogenesis of EP is hormone-dependent disease, this may provide a theoretical basis for the therapy. P63protein gene in polyps was significantly higher expression also illustrates the formation of polyps may be underlayer indicates that the EP originates from the basal resever stem cell, which has the major potential of proliferation.Part II. Clinical analysis of hysterosocopy in the diagnosis and treatment of200cases with endometrial polyps[Object] We restropectively analyzed the clinical efficacy of hyteroscopy in the diagnosis and treatment of200endometrial polyps,and explore the advantages of hysteroscopy. Through these statistics, we aimed to get more detailed information of endometrial polyps and to provide evidences for the diagnosis and treatment.[Method] Two hundred cases of endometrial polyps, which were diagnosed by hysteroscopy in our hospital from January2012to August2012, were analyzed restrospectively. We analyzed the distribution of the patient’s age, menstrual history, clinical symptoms, birth history, mode of delivery, imaging findings, surgical approach, intraoperative findings, postoperative pathology clinical summary. SPSS19.0statistical software was used for statistical analysis, the related factors to the incidence of endometrial polyps was analyzed. We also analyzed the morphological characteristics of polyps in different menstrual status.[Result] Among the200cases endometrial polyps,132cases were premenopausal, accounting for66%of the average age of38.19±7.68years old;68cases were postmenopausal, accounting for34%, with an average age of58.91±4.58; The history of abnormal vaginal bleeding was found in42cases, while the history of asymptomatic was found in148cases. The consistent accuracy rate between hysteroscopic diagnosis with pathological diagnosis was of73.5%.[Conclusion] The clinical manifestations of asymptomatic endometrial polyps were mainly found by physical examination. In premenopausal patients, multiple polyps were common.While in postmenopausal patients, the solitary polyps were common. The consistent accuracy rate between hysteroscopic diagnosis with pathological diagnosis was of73.5%. Hysteroscopy is still the primary means of diagnosis and treatment of endometrial polyps. Although its low malignant endometrial polyps still should be pay attention to.