Histological significance of MPO, ER, and PR in endometrial polyps of premenopausal women.

Abstract

BACKGROUND: Endometrial polyps (EP) can lead to irregular bleeding and infertility in women. The identification of biomarkers associated with EP holds clinical importance. METHODS: Patients who visited the hospital due to abnormal uterine bleeding, endometrial thickening, abnormal menstruation, lower abdominal pain, infertility, or repeated miscarriages were included. Thirty-four patients were diagnosed with EP; 32 patients with no previous history of EP and negative histological results were taken as the control. The expression levels of MPO, ER, PR, MMP2, MMP9, PCNA, and COX2 in the two groups were assessed by immunohistochemistry and western blot. The relationships between MPO, ER, and PR, and clinicopathological characteristics, inflammation, hormones, and glycolipid metabolism of EP patients, were also analyzed. RESULTS: The expression of MPO, ER, MMP2, MMP9, PCNA, and COX2 in the EP group was markedly increased, while that of PR was markedly reduced. In EP tissues, MPO had a positive correlation with ER and a negative correlation with PR. Increased MPO expression was associated with abnormal uterine bleeding, polyp size exceeding 1 cm, endometrial proliferation stage, and higher VAS pain score. Increased ER expression was associated with multiple polyps and larger polyp size. Reduced PR expression was associated with multiple polyps and endometrial secretory phase. In addition, increased MPO expression was associated with increased levels of CRP and PLR and reduced hemoglobin levels. CONCLUSION: MPO and ER in EP are significantly upregulated, while PR is significantly downregulated. Increased MPO expression is associated with elevated inflammatory markers and reduced hemoglobin levels, while ER/PR imbalance is related to multiple polyps and polyp size.