Effect of menstrual cycle and hormonal treatment on ki-67 and bcl-2 expression and adenomyosis

Hugo Maia, Maia H Jr, Amélia Maltez, Maltez A, Studart E, Eduardo Studart, Célia Athayde, Athayde C, Elsimar Metzker Coutinho, Elsimar M Coutinho, Coutinho Em
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2005 · vol. 20(3) , pp. 127–131 · doi:10.1080/09513590400021086 · PMID:16019350 · W2055394776
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Ki-67 and Bcl-2 expression in adenomyotic lesions increased during the proliferative phase and decreased in the luteal phase, with hormonal treatments showing varied effects.

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Abstract

OBJECTIVE: To study the expression of proliferation markers (ki-67) and anti-apoptotic protein (bcl-2) in adenomyotic lesions during the menstrual cycle or following the use of steroid hormones. PATIENTS AND METHODS: Ninety patients of reproductive age were included, who were submitted to endometrial resection for treatment of adenomyosis-related menorrhagia. Seven patients were using oral contraceptives and another seven had a levonorgestrel intrauterine device (IUD) (Mirena) in the uterine cavity at the time of the hysteroscopic procedure. Untreated patients were divided into four groups: menstruation/early proliferative phase (n = 24), late proliferative (n = 19), early luteal phase (n = 7) and late luteal phase (n?=?26). Bcl-2 and ki-67 expression was determined in paraffin-embedded tissue blocks using immunohistochemical methods. RESULTS: Proliferation rates in adenomyotic lesions increased during the proliferative phase, reaching a peak during ovulation to decrease to values close to zero in the late luteal phase. Bcl-2 expression showed a similar curve with peak values during the later proliferative phase followed by a significant decrease in the number of cases showing strong positive expression in the late luteal phase. Both Mirena and oral contraceptives decreased ki-67 expression on adenomyosis but only Mirena was affective in diminishing bcl-2 expression. CONCLUSION: During the luteal phase, both ki-67 and bcl-2 expression is reduced in adenomyotic lesions in a similar way to that occurring in patients using Mirena. Oral contraceptives, on the other hand, do not affect bcl-2 expression in adenomyosis.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Ki-67 Antigen Menstrual Cycle Proto-Oncogene Proteins c-bcl-2 Adult Apoptosis Cell Division Contraceptives, Oral Contraceptives, Oral Endometriosis Endometriosis Female Follicular Phase Humans Immunohistochemistry Ki-67 Antigen Levonorgestrel Levonorgestrel Luteal Phase Middle Aged

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