title: TNFalpha expression in hyperplastic endometrium.
abstract: OBJECTIVE
  Tumor necrosis factor-alpha (TNFalpha) is produced by the endometrium, and it has been shown that this cytokine has cyclic variations through the menstrual cycle.
  
  
  METHODS
  In this study we assessed TNFalpha, estradiol and progesterone levels in the endometrium and serum of 21 patients with recent abnormal uterine bleeding (AUB). Eleven women showed histological diagnosis of endometrial hyperplasia, and ten women showed normal endometrium.
  
  
  RESULTS
  The TNFalpha value in the serum of patients with hyperplasia and in normal endometrium did not show significant differences (64.8 +/- 21.4 vs 77.6 +/- 14.8 pg). The amounts of TNFalpha released by hyperplastic endometrial tissue were significantly higher than in control patients (258.8 +/- 78.0 vs 140.6 +/- 79.8 pg/g; P < 0.001). Immunohistochemistry of hyperplastic endometria showed a stronger staining than normal ones. Serum E2 levels in patients with hyperplastic endometrium were 49.5 +/- 31.6 ng/mL, and in controls were 107.3 +/- 66.0 ng/mL. The levels of estradiol released by hyperplastic endometria were significantly lower than in normal endometria (152.7 +/- 60.0 vs 279.9 +/- 178.7 ng/g; P < 0.003).
  
  
  CONCLUSIONS
  Hyperplastic endometria produce higher amounts of TNFalpha with respect to controls. These findings may explain the frequent bleeding observed in the patients with endometrial hyperplasia, since TNFalpha promotes apoptosis and endometrial shedding.
authors.affiliation: Department of Obstetrics and Gynecology, Tor Vergata University of Rome, S.Eugenio Hospital, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Zupi
authors.forename: M
authors.initials: M
authors.lastname: Sbracia
authors.forename: D
authors.initials: D
authors.lastname: Marconi
authors.forename: P
authors.initials: P
authors.lastname: Alò
authors.forename: G
authors.initials: G
authors.lastname: Atzei
authors.forename: T
authors.initials: T
authors.lastname: Brazolin
authors.forename: D
authors.initials: D
authors.lastname: Arduini
authors.forename: C
authors.initials: C
authors.lastname: Romanini
mesh_terms: D004714:Endometrial Hyperplasia / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D004958:Estradiol / Q000032:analysis; D005260:Female; D006801:Humans; D011374:Progesterone / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D014592:Uterine Hemorrhage / Q000209:etiology* / Q000276:immunology
chemical_list: D014409:Tumor Necrosis Factor-alpha; D011374:Progesterone; D004958:Estradiol