| Objective:1.The expression of TGF-β1,MMP-9 and E-cadherin in Intrauterine adhesion tissues and normal endometrial tissues were detected by immunohistochemistry,which provided further evidence for the study of pathogenesis and treatment of uterine adhesions.2.To analyze the relationship between the expression of TGF-β1,MMP-9,E-cadherin and age,AFS grade,curettage times,amenorrhea,the opening of fallopian tube,the material of adhesion,and the extent of adhesion,which explored the related factors of pathogenesis,so as to provide basis for clinical diagnosis and treatment.3.To analyze the expression of TGF-β1,MMP-9 and E-cadherin in endometrium of patients with intrauterine adhesions,to provide clinical basis for the study of pathogenesis.Methods:From January 2019 to January 2020,30 cases of Intrauterine adhesion tissues samples of patients with intrauterine adhesions who admitted to the Department of Gynecology,the First Affiliated Hosipital of Kunming Medical Unibersity and the Tong Ren Hosipital of Kunming were collected as the observation group.And 30 cases of endometrial tissue samples in normal hyperplasia period confirmed by pathological results after curettage were collected as control group.The patients of observation group age range is between 25-43,with an average of(32.93±5.33);according to the AFS classification of the American Fertility Association,8 cases of mild intrauterine adhesions,15 cases of moderate intrauterine adhesions,7 cases of severe intrauterine adhesions;there were 20 patients with curettage times less then 2,19 patients with greater than or equal to 2;there were 8 cases with amenorrhea,22 cases without amenorrhea;there were 7 cases with double fallopian tube opening,11 cases were unilateral opening;6 cases were membranous,12 cases were fibrotic,12 cases were myogenic,about adhesion range,6 cases were<1/3,18 cases were 1/3-2/3,6 cases were>2/3.The patients of control group age range is between 22-43,with an average of(31.40±4.31),all of them are normal hyperplasia endometrial tissue.The expression of TGF-β1,MMP-9 and E-cadherin were detected by immunohistochemistry,and the interpretation was carried out by taking into account the intensity of positive staining and the percentage of positive cells.The data were analyzed statistically.The expression of TGF-β1,MMP-9 and E-cadherin in endometrium of the observation group and the control group were compared.The expression of TGF-β1,MMP-9 and E-cadherin in the endometrium of the observation group was analyzed in relation to the age,the classification of AFS,the frequency of curettage,amenorrhea,the nature of adhesions and the range of adhesions.The correlation of the expression between TG-(31,MMP-9 and E-cadherin in endometrium of the observation group was analyzed.Results:1.The patients of observation group age range is between 25-43,with an average of(32.93±5.33),and the average number of pregnancies was(2.43±1.48);The patients of control group age range is between 22-43,with an average of(31.40±4.31),and the average number of pregnancies was(1.93±0.83).There was no statistical difference between the two groups(P>0.05).2.The IRS scores of TGF-β1,MMP-9 and E-cadherin in endometrium of the observation group and the control group were compared.The expression of TGF-β1 in endometrium of the observation group was higher than that of the control group(P<0.05).The expression of MMP-9 in the endometrium of the observation group was lower than that of the control group(P<0.05).The e-cadherinirs score of the observation group was 2.70±0.76,and that of the control group was 7.70±1.13.The expression of e-cadherinirs in the endometrium of the observation group was lower than that of the control group,with a statistically significant difference(P<0.05).3.The expression of TGF-β1,MMP-9 and E-cadherin in the endometrium of the observation group was correlated with the clinicopathological features.The expression of TGF-β1 was related to the classification of AFS,the condition of fallopian tube opening,the nature of adhesions and the range of adhesions.According to the classification of AFS,the expression of TGF-β1 in endometrial tissue of patients with mild,moderate and severe intrauterine adhesions was significantly increased(P<0.05);with the condition of fallopian tube opening becoming worse,the expression of TGF-β1 was significantly increased(P<0.05).The expression of TGF-β1 in endometrial tissue of patients with adhesions of membranous,fibrotic and myogenic was significantly increased(P<0.05);the larger the adhesions,the higher the expression of TGF-β1 in endometrial tissue of patients with adhesions of uterine cavity was(P<0.05).TGF-β1 expression and age,curettage times,amenorrhea(P>0.05).The expression of MMP-9 was related to AFS grade and adhesion range.The expression of MMP-9 in endometrial tissue of patients with AFS grade of mild adhesions was higher than that of patients with AFS grade of moderate and severe adhesions,the difference was statistically significant(P<0.05).The expression of MMP-9 in endometrial tissue of patients with AFS grade of moderate adhesions was statistically significant(P<0.05)The expression of MMP-9 in endometrial tissue was significantly higher than that in AFS,and the difference was statistically significant(P<0.05).The expression of MMP-9 was not related to age,curettage times,salpingostomy and adhesiveness(P>0.05).The expression of E-cad herin in the endometrium of the patients with AFS was higher than that of the patients with AFS(P<0.05)The expression of E-cadherin in endometrial tissue of patients with membranous adhesions was higher than that of patients with fibrous adhesions and myogenic adhesions(P<0.05),The expression of E-cad herin in endometrial tissue of fibroid adhesions was significantly higher than that of fibroid adhesions(P<0.05).The expression of E-cadherin was not related to age,frequency of curettage,amenorrhea and fallopian tube opening(P>0.05).4.The expression of TGF-β1,MMP-9 and E-cadherin in endometrium of the observation group was correlated.The expression of GF-β1 was negatively correlated with the expression of MMP-9(r=-0.720,P<0.05)and E-cadherin(r=-0.893,P<0.05),and the expression of MMP-9 was positively correlated with the expression of E-cadherin(r=0.802,P<0.05).Conclusions:1.The expression of transforming factor-β1(TGF-β1)is high in the endometrial tissue of intrauterine adhesions,and the expression of matrix metalloproteinase-9(MMP-9)and E-cadherin is low in the endometrial tissue of intrauterine adhesions.2.The higher the level of AFS,the more serious the gross pathological changes,the higher the expression of TGF-β1,the lower the expression of MMP-9 and E-cadherin.TGF-β1 may play an important role in the occurrence and progression of uterine adhesions.MMP-9 and E-cadherin may play an important role in the occurrence and progression of uterine adhesions It plays an inhibitory role in development.3.The expression of transforming factor-β1(TGF-β1),matrix metalloproteinase-9(MMP-9)and E-cadherin were negatively correlated with MMP-9 and E-cadherin,MMP-9 was positively correlated with E-cadherin,TGF-β1 was negatively correlated with MMP-9 and E-cadherin,and TGF-β1 was negatively correlated with MMP-9 and E-cadherin The three cytokines may participate in the occurrence and development of the disease. |
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