To Quantitatively Study The Nerve And Blood Vessel In Eutopic Endometrium Of Patients With Adenomyosis

Objective: To investigate the nerve(including total nerve,sympathetic nerve,parasympathetic nerve and newborn nerve)in eutopic endometrium of patients with adenomyosis and its relationship with dysmenorrhea,and analyze the blood vessels in eutopic endometrium and its correlation with menstrual volume by the clinical and morphological study.Methods: 30 cases of adenomyosis patients with hysterectomy in our hospital from June 2015 to June 2016 were recruited in the present study,while another 20 patients with hysterectomy due to cervical intraepithelial neoplasia grade 3(CIN3)were enrolled as a control group in the same period.All patients were diagnosed by pathological examination.Visual analog scale(VAS)score was used to assess the pain degree of dysmenorrhea in patients with adenomyosis,and these patients were divided into two groups(low VAS group and high VAS group)according to the VAS score.After hysterectomy,the excised uteri in the study subjects were cut quickly.The eutopic endometrium and deep myometriumfrom in patients with adenomyosis as well as normal uterine tissue from the control group were obtained.The specimens were fixed with paraformaldehyde,and the embedded sections with paraffin were observed by hematoxylin and eosin(HE)staining.After immunohistochemical staining,the positive rate of the total nerve,sympathetic nerve,parasympathetic nerve,newnborn nerve and blood vessels in the endometrium were calculated and analyzed.Results: the amount of total nerve,sympathetic nerve,parasympathetic nerve and newborn nerve fiber density as well as blood vessel density in subjects with high VAS group and low VAS group were both significantly higher than that in control group(P<0.05).The total nerve fiber density and sympathetic nerve fiber density in high VAS group were significantly higher than those in low VAS group(P<0.05),however,there was no significant difference in parasympathetic nerve fiber density,new nerve fiber density and vascular density between the two groups.To analyze the relationship between nerve fiber density and VAS score,linear regression analysis indicated that the total nerve fiber density(R=0.927,P<0.001)and sympathetic nerve density(R=0.911,P<0.001)were significantly correlated with the VAS score in patients with adenomyosis,while the parasympathetic nerve and newborn nerve fiber density were not associated with VAS score.To analyze the correlation between endometrial vascular density and menstrual volume,linear regression analysis showed that uterine endometrial vascular density was significantly correlated with menstrual volume(R=0.781,P<0.001).Conclusion: the nerve fibers density and vascular density in the endometrium of patients with adenomyosis were significantly increased.The total nerve fibers density and sympathetic nerve fibers density were closely correlated with the secondary dysmenorrhea,and the blood vessel density was significantly associated with the menstrual volume.