To explore the expression and clinical significance of CXCL12/CXCR4/CXCR7 mRNA and its protein in endometrium and myometrium of patients with adenomyosis (AM).

From January 2016 to December 2017, a total of 30 patients who underwent total or subtotal hysterectomy or lesion resection and were diagnosed as AM by histopathological examination in Department of Obstetrics and Gynecology, Taizhou First People′s Hospital were selected as research subjects and were enrolled into study group (n=30). Another 30 patients who underwent total or subtotal hysterectomy and were diagnosed as uterine fibroids by histopathological examination in the same hospital during the same period were selected as control and enrolled into control group (n=30). In study group, eutopic endometrium tissues and myometrium tissues with ectopic lesions were retained during operation. In control group, the eutopic endometrium and normal myometrium tissues were retained during operation. CXCL12/CXCR4/CXCR7 mRNA and its protein expression levels in tissues of two groups were evaluated by real-time fluorescence quantitative PCR and Western blotting methods, and were compared by independent-samples t test. This study was approved by the Ethics Committee of Taizhou First People′s Hospital (Approval No. 2015-KY004-08). Informed consents were obtained from all subjects. There were no statistically significant differences in general clinical data between two groups, such as age and so on (P>0.05).

①The expression levels of CXCL12 mRNA in eutopic endometrium tissue and myometrium tissue with ectopic foci of study group were (0.05±0.01) and (0.24±0.03) respectively, which were both significantly higher than those of control group (0.02±0.01) and (0.11±0.02), and both the differences were statistically significant (t=2.707, P=0.014; t=3.196, P=0.009). Expression level of CXCR7 mRNA in eutopic endometrium tissue of study group was (0.007±0.002), which was significantly higher than that of control group (0.002±0.000), and the difference was statistically significant (t=2.226, P=0.035), while there was no statistical difference between two groups in expression level of CXCR4 mRNA in myometrium tissue (P>0.05). ②There were no statistical differences between two groups in expression levels of CXCL12 protein both in eutopic endometrium and myometrium tissues (P>0.05). Expression level of CXCR7 protein in eutopic endometrium tissue of study group was (0.88±0.19), which was significantly higher than that of control group (0.72±0.17), while expression level in myometrium tissue was (0.69±0.21), which was significantly lower than that of control group (1.09±0.29), and both the differences were statistically significant (t=2.016, P=0.046; t=-2.807, P=0.019). Expression level of CXCR4 protein in eutopic endometrium tissue of study group was (2.08±0.27), which was significantly lower than that of control group (2.99±0.87), and the difference was statistically significant (t=-2.228, P=0.036), while expression level of CXCR4 protein in myometrium tissue of two groups were not statistically significant (P>0.05).

CXCL12/CXCR4/CXCR7 plays a role in the occurrence and development of AM, and its mechanism may be related to CXCR7. The expression of CXCL12 in AM shows regulation at transcriptional level.