Abstract
The objective of the present study was to investigate differences in the expression of apoptosis-related factors in the eutopic and ectopic endometrium (EuE/EE) in women with adenomyosis before and after laparoscopic bilateral uterine artery occlusion (LUAO). Ten patients with uterine adenomyosis who received LUAO were selected as the research subjects, from whom EuE and EE tissues were obtained before and after LUAO and detected for the expression of apoptosis-related molecules in EuE and EE by PT-PCR and Western blot, and changes in the mitochondrial structure by electron microscopy. Normal endometrial stromal cells (NESC), and EuE/EE stromal cells in women with adenomyosis were cultured in a 1% O2, 5% CO2 incubator to establish a physical anoxia state in an in vitro stromal cell model. The expression of apoptosis-related molecules was observed at 0, 6, 12, 24 and 48h of hypoxic. The results showed that the expression of apoptosis-related factors in EuE and EE were increased significantly after LUAO and under hypoxic conditions in vitro, suggesting that transient ischemia and hypoxia were involved in the apoptosis of adenomysis lesions, and that uterine artery occlusion could remove adenomyosis lesions on tissue/cell level by cytoreduction, thus reaching the goal of treating adenomyosis effectively.
Highlights
Adenomyosis is a common chronic disease primarily diagnosed in childbearing females
A study by Nijenhuis etal[6] reported that uterine artery embolism (UAE) using polyzene F-coated hydrogel microspheres showed good clinical outcomes in (97%) of their patients with treatmentresistant adenomyosis, and hysterectomy was required in only one patient
The result showed that eutopic endometrium (EuE) and EE tissues underwent apoptosis after laparoscopic uterine artery occlusion (LUAO), presenting typical apoptosis characteristics such as swollen mitochondria, cavitation sample change, nuclear chromatin edge, cell membrane reflex, cytoplasmic concentration and the formation of apoptotic bodies
Summary
Adenomyosis is a common chronic disease primarily diagnosed in childbearing females. It is defined as the presence of endometrial glands and stroma causing reactive hyperplastic or hypertrophic myometrium., surrounded by chronic inflammation in the endometrium [1,2,3,4]. The result showed that the postoperative menstrual quantity was decreased significantly and the uterus volume was reduced by 58.3% in these patients during the 36-months follow-up period Their health-related quality of life was improved significantly as compared with that before treatment. Our preliminary clinical practices have demonstrated that LUAO combined with partial resection for the treatment of adenomyosis is safe and effective, and the overall outcome is superior to that reported in the literature[13]. This technology has been incorporated into the uterus adenomyosis classification treatment as an independent operation [5]
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