Compared the expression of endoplasmic reticulum stress and their adaptive molecule mRNA in endometriosis and gynecologic cancer

Endometriosis is benign disease but it has very similar pathologic patterns of invasion with gynecologic cancer. The role of endoplasmic reticulum (ER) stress in endometriosis and gynecologic cancer is unknown. This study compared the levels of expression of ER stress-associated genes and the clinical manifestations in patients with endometriosis or gynecologic cancer. The levels of expression of ER stress mRNAs, including those encoding C/EBP-homologous protein (CHOP), X-box binding protein 1 (sXBP1), activating transcription factor 6 (ATF6), immunoglobulin heavy chain-binding protein (BiP), inositol-requiring enzyme 1α (IRE1α), and endoplasmic reticulum kinase (PERK), were measured by real time polymerase chain reaction in the peritoneal fluid of patients in control group (benign gynecologic disease without endometriosis), endometriosis group, and gynecologic cancer group. The expression of ER stress mRNA and the associated clinical manifestations in the three groups were compared. The expression levels of CHOP and Bip mRNA were higher in the control group. Levels of sXBP1, ATF6, IRE1α, and PERK mRNA expression were higher in the cancer group. Among them, sXBP1 and ATF6 mRNA expression was significantly higher in the cancer group than in the control and endometriosis groups (p<0.05). In the endometriosis group, ATF6 mRNA level negatively correlated with age and positively correlated with serum CA 125, and PERK mRNA level negatively correlated with parity (p<0.05, each). ER stress-related mRNAs are related to the pathogenesis of endometriosis and gynecologic cancers. Increased expression of CHOP and Bip mRNA is more likely to be associated with benign lesions, while increased expression of sXBP1 and ATF6 mRNA is more likely to be associated with malignant lesions.