Expression of Survivin, Estrogen Receptor and Progesterone Receptor of Endometrium of Patients With Anovulatory Dysfunctional Uterine Bleeding Before and After Radiofrequency Heat-Coagulation Treantment

Objective To investigate the mechanism of radiofrequency(RF) heat-coagulation treatment of anovulatory dysfunctional uterine bleeding (DUB) by testing the expression levels of survivin, estrogen receptor(ER) and progesterone receptor (PR) in endometrium before and half year after treatment. Methods From June 2003 to December 2008, 76 cases of endometrium with anovulatory dysfunctional uterine bleeding had undergone radiofrequency heat-coagulation treatment in the Department of Gynecology, the Military General Hospital of Jinan PLA. Pathological diagnosis of endometrial tissue from diagnostic curettage showed that 32 cases of simple hyperplasia, 28 of complex hyperplasia, and 16 of proliferative endometrium before treatment. A total of 76 cases were divided into A-type RF group and B-type RF group according to different ways of radiofrequency. A-type RF group conducted all endometrial coagulation-A-type coagulation, and B-type RF group conduced all endometrial coagulation-B-type coagulation. At the same time, another thirty-eight cases with anovulatory dysfunctional uterine bleeding women were treated by conservative treatment (control group). Pathological diagnosis of endometrial tissue from diagnostic curettage showed that 16 cases of simple hyperplasia, 12 of complex hyperplasia, and 10 of proliferative endometrium before treatment. Other gynecological diseases and gynecological cancer were not found in both two groups. All of them had not received any hormonal treatment measures nearly a month. Informed consent was obtained from all participants. There was no significant difference of age between two groups (P>0.05). The expression levels of survivin, estrogen receptor and progesterone receptor were detected by immunohistochemical S-P method before and follow-up 6 to 12 months after the treatment. Results ①Pathological types of endometrial tissue from diagnostic curettage before and follow-up 6 to 12 months after treatment showed no significant difference of control group (P>0.05). ② Expressive levels of survivin, estrogen receptor and progesterone receptor after the treatment had no significant difference between two groups (P>0.05). Pathological types of endometrial tissue from diagnostic curettage of study group showed significant difference before and follow-up 6 to 12 months after the treatment of study group (P 0.05). ④There were obviously statistical decrease of expressive levels of survivin, estrogen receptor and progesterone receptor after radiofrequency treatment in half a year than those before the treatment of study group (P<0.05). Conclusion The continued lower levels of survivin, estrogen receptor and progesterone receptor of the anovulatory dysfunctional uterine bleeding patients in study group is one of the important mechanism for treating anovulatory dysfunctional uterine bleeding by radiofrequency method. Key words: anovulatory dysfunctional uterine bleeding (anovulatory DUB); radiofrequency heat-coagulation treatment(RF); survivin; estrogen receptor(ER); progesterone receptor (PR)