School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil ; School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil ; School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil.
Int J Womens Health. 2013 Jun 13;5:293-9. doi: 10.2147/IJWH.S45093. Print 2013.
The presence of aromatase and cyclooxygenase-2 (Cox-2) expression was investigated in the endometrium of patients with idiopathic menorrhagia or adenomyosis. The effect of oral contraceptives administered in extended regimens on the endometrial expression of these enzymes was also investigated.
Aromatase expression was detected by immunohistochemistry in the endometrial glands and stroma of patients with idiopathic menorrhagia or adenomyosis. There was no difference in the percentage of aromatase expression in the endometria between the two groups. The mean intensity of Cox-2 expression in the glandular epithelium also did not differ significantly between the groups. Among the patients using oral contraceptives in extended regimens, the relative decrease in both aromatase and Cox-2 expression was significantly greater in amenorrheic patients compared with those who were experiencing breakthrough bleeding.
The presence of aromatase expression in the endometrium is associated with the occurrence of menorrhagia, irrespective of the presence of adenomyosis. Continuous expression of these enzymes in the endometrium of users of oral contraceptives in extended regimens is positively associated with the presence of breakthrough bleeding. This suggests a role for both aromatase and Cox-2 in the etiology of abnormal uterine bleeding.
本研究旨在探讨特发性月经过多或子宫腺肌病患者子宫内膜中芳香酶和环氧化酶-2（Cox-2）的表达情况，并研究延长服用避孕药对这些酶在子宫内膜中表达的影响。
采用免疫组织化学方法检测特发性月经过多或子宫腺肌病患者子宫内膜中芳香酶的表达。两组患者子宫内膜中芳香酶的表达百分比无差异。两组患者子宫内膜中腺上皮 Cox-2 的表达强度也无显著差异。在延长服用避孕药的患者中，与突破性出血患者相比，闭经患者的芳香酶和 Cox-2 表达相对下降更为明显。
子宫内膜中芳香酶的表达与月经过多的发生有关，与是否存在子宫腺肌病无关。延长服用避孕药的患者中这些酶在子宫内膜中的持续表达与突破性出血的发生呈正相关。这表明芳香酶和 Cox-2 在异常子宫出血的病因学中发挥作用。
