Khan Khaleque N, Fujishita Akira, Kitajima Michio, Masuzaki Hideaki, Nakashima Masahiro, Kitawaki Jo
Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Obstetrics and Gynecology, Graduate school of Biomedical Sciences, Nagasaki University, Japan.
Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Eur J Obstet Gynecol Reprod Biol. 2016 Aug;203:49-55. doi: 10.1016/j.ejogrb.2016.05.012. Epub 2016 May 20.
Endometriosis is commonly believed to originate from functionalis endometrium and adenomyosis from basalis endometrium. Due to the lack of enough information, we investigated the biological differences between these two layers of endometrium in women with and without adenomyosis.
This was a case-controlled study with 12 control women and 17 women with adenomyosis undergoing hysterectomy. Full thickness (extending from the endometrium to the myometrium) biopsy specimens were obtained after the hysterectomy. Based on the phases of the menstrual cycle, the expression patterns of estrogen receptor (ER), progesterone receptor (PR), Ki-67, and activated Caspase-3 were analyzed by immunohistochemistry in the functionalis and basalis endometria. Apoptotic cells were evaluated by TdT-mediated dUTP-biotin nick end-labeling (TUNEL) assay.
A similar pattern of ER and PR expression was found in the functionalis and basalis endometria during the proliferative phase. In contrast, a significantly lower ER and PR expression was found in the basalis endometria than in the functionalis endometria during the secretory phase and the menstrual phase. This was equally observed in control women and in women with adenomyosis. Except Ki-67 indices, TUNEL-positive cells, and expression of activated Caspase-3 were significantly lower in the basalis endometria than in the functionalis endometria during the secretory phase.
A significant biological difference was found between the functionalis and the basalis endometria derived from women with adenomyosis.
子宫内膜异位症通常被认为起源于功能层子宫内膜，而子宫腺肌病起源于基底层子宫内膜。由于缺乏足够的信息，我们研究了有和没有子宫腺肌病的女性这两层子宫内膜之间的生物学差异。
这是一项病例对照研究，12名对照女性和17名患有子宫腺肌病的女性接受了子宫切除术。子宫切除术后获取全层（从子宫内膜延伸至肌层）活检标本。根据月经周期阶段，通过免疫组织化学分析功能层和基底层子宫内膜中雌激素受体（ER）、孕激素受体（PR）、Ki-67和活化的半胱天冬酶-3的表达模式。通过TdT介导的dUTP生物素缺口末端标记（TUNEL）法评估凋亡细胞。
在增殖期，功能层和基底层子宫内膜中ER和PR的表达模式相似。相反，在分泌期和月经期，基底层子宫内膜中ER和PR的表达明显低于功能层子宫内膜。在对照女性和患有子宫腺肌病的女性中均观察到这一情况。除了Ki-67指数外，在分泌期，基底层子宫内膜中TUNEL阳性细胞和活化的半胱天冬酶-3的表达明显低于功能层子宫内膜。
发现患有子宫腺肌病的女性的功能层和基底层子宫内膜之间存在显著的生物学差异。
