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



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.



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.



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.
Maia
Hugo
H
CEPARH, Salvador, Bahia, Brazil. ceparh@uol.com.br
Maltez
Amélia
A
Studart
Eduardo
E
Athayde
Célia
C
Coutinho
Elsimar M
EM
D000328:Adult; D017209:Apoptosis; D002455:Cell Division; D003276:Contraceptives, Oral / Q000008:administration & dosage; D004715:Endometriosis / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005498:Follicular Phase; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D016912:Levonorgestrel / Q000008:administration & dosage; D008183:Luteal Phase; D008597:Menstrual Cycle; D008875:Middle Aged; D010060:Ovulation; D010232:Paraffin; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D012189:Retrospective Studies; D016610:Tissue Embedding
D003276:Contraceptives, Oral; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D016912:Levonorgestrel; D010232:Paraffin