title: Biological differences between functionalis and basalis endometria in women with and without adenomyosis.
abstract: OBJECTIVE
  Endometriosis is commonly believed to originate from functionalis endometrium and adenomyosis from basalis endometrium. Due to the lack of enough information, we investigated the biological differences between these two layers of endometrium in women with and without adenomyosis.
  
  
  METHODS
  This was a case-controlled study with 12 control women and 17 women with adenomyosis undergoing hysterectomy. Full thickness (extending from the endometrium to the myometrium) biopsy specimens were obtained after the hysterectomy. Based on the phases of the menstrual cycle, the expression patterns of estrogen receptor (ER), progesterone receptor (PR), Ki-67, and activated Caspase-3 were analyzed by immunohistochemistry in the functionalis and basalis endometria. Apoptotic cells were evaluated by TdT-mediated dUTP-biotin nick end-labeling (TUNEL) assay.
  
  
  RESULTS
  A similar pattern of ER and PR expression was found in the functionalis and basalis endometria during the proliferative phase. In contrast, a significantly lower ER and PR expression was found in the basalis endometria than in the functionalis endometria during the secretory phase and the menstrual phase. This was equally observed in control women and in women with adenomyosis. Except Ki-67 indices, TUNEL-positive cells, and expression of activated Caspase-3 were significantly lower in the basalis endometria than in the functionalis endometria during the secretory phase.
  
  
  CONCLUSIONS
  A significant biological difference was found between the functionalis and the basalis endometria derived from women with adenomyosis.
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Obstetrics and Gynecology, Graduate school of Biomedical Sciences, Nagasaki University, Japan. Electronic address: nemokhan@koto.kpu-m.ac.jp.
authors.forename: Khaleque N
authors.initials: KN
authors.lastname: Khan
authors.affiliation: Saiseikai Nagasaki Hospital, Nagasaki, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fujishita
authors.affiliation: Department of Obstetrics and Gynecology, Graduate school of Biomedical Sciences, Nagasaki University, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Kitajima
authors.affiliation: Department of Obstetrics and Gynecology, Graduate school of Biomedical Sciences, Nagasaki University, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Masuzaki
authors.affiliation: Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakashima
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Jo
authors.initials: J
authors.lastname: Kitawaki
mesh_terms: D062788:Adenomyosis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000328:Adult; D016022:Case-Control Studies; D053148:Caspase 3 / Q000378:metabolism; D004717:Endometrium / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D053148:Caspase 3
keywords: Adenomoyisis; Basalis endometrium; Biological differences; Functionalis endometrium