Expression of estrogen and progesterone receptor and matrix metalloproteinases in the endometrium of patients with anovulatory dysfunctional uterine bleeding

Objective: To investigate the expression of estrogen receptor(ER),progesterone receptor(PR),(collagen) IV and matrix metalloproteinase(MMPs) in the endometrium of patients with anovulatory(dysfunctional) uterine bleeding(DUB).Methods: Immunochemical SP technique was used to determine the expression of ER,PR,collagen IV,MMP-9 and TIMP-1 in the endometrium of 20 patients with normal menstrual cycle and 66 with(anovulatory) DUB.Results: Expression of ER and PR was significantly higher in the DUB endometrium with simplex and complex hyperplasia in comparison with the normal proliferative endometrium(P0.05).MMP-9(immunoreactivity) in glandular epithelial cells and MMP-9/ TIMP-1 ratio were significantly higher in DUB endometrium with simplex and complex hyperplasia than those in the normal proliferative endometrium((P0.01),) while expression of collagen IV was significantly lower in the endometrial stroma of DUB(patients.) MMP-9 was positively correlated with ER(r=0.605,P0.05) and PR(r=0.697,P0.05). Conclusions: The abnormal bleeding in DUB patients with simplex and complex endometrium hyperplasia might be associated with the abnormal expression of endometrial ER and PR,and with(up-regulation) of activity of MMP-9 in the endometrium which causes over-degradation of the ECM.