(Directed by Prof. Dong Sik Kim, M.D. Prof. Yoo Bock Lee, M.D.)
The endometrium undergoes marked morphelogic and functional changes in a vey
short period of time, and these are controlled by overian hormones. These changes
of the endometrium ar fundamentally based on the biochemical alterations. The
endometrium is composed of surface and glandular epithelium, connective tissue, and
blood vessels, all of which participate in the morphologic alteration during the
cyclic changes, Thus, to understand the mechanisms of morphologic alterations and
the basis of endometrial function, histochemical studies concerning the
localisation of specific chemical and enzymatic activity are very important (Mckay,
et al.,1956**a ; Levine, 1963).
It is the purpose of this report (1) to evaluate histochemical patterns during
the normal cyclic processes of the endometrium, and (2) to search for the
histochemical differences in various conditions of endometrium from that of normal
endometrium.
Material and Methods
Ninety endometris curetted from normal and abnormal uteri were obtained from the
Department of Obstetrics and Gynecology, Severance Hospital. The histologic
criteria of Noyes, et al. (1951) were used to establishthe state of each specimen.
Of the 25 normal specimens, 9 were proliferative, 14 were secretory, and 2 were
menstrual. And the 65 abnormal endometria consisted of 16 with intrauterine
pregnancies, 16 with extrauterine pregnancien, 25 with hyperplasia, 3 with atypical
hyperplasia, 3 with adenocarcinoma, and 2 with endometrial polyp. A portion of each
specimen was frozen-sectioned and prepared for the activity of alkaline phosphatase
by Gomori's metal-salt method (1939).
The remainder of each specimen was fixed in 10% neutral formalin solution. The
paraffin-embedded sections were stained by hematoxylin and eosin, periodic
acid-Schiff reachtion for glycogen and glycoprotein, alcian blue stain for acid
mucopolysaccharides, and methylgreen pyronin stain for ribonucleic acid.
Results and Summary
1. The PAS positive material, regarded as glycogen or glycoprotein, underwent the
cyclic changes in surface as well as glandular epithlium of the normal endometrium;
the amount of the material was greater in the sectetory endometrium than in the
proliferative endometrium and was also large in the endometria of intra-as well as
extrauterine pregnancies. But in hyperplasia and adenocarcinoma, the PAS positive
material was small in amount like in the proliferative endometrium.
2. The acid mucopolysaccharides which were located chiefly along the brush border
of epithelium and in the stroma, reealed its cyclicity, and increased in the
secretory endometrium.
3. It was an interesting finding that diffuse intracyto-plasmic location of acid
mucopolysaccharides was observed only in hyperplastic and cancerous endometria.
4. No significant histochemical differences were found in the endometria between
intra-and extrauterine pregnancies.
5. The Arias-Stella atypias were observed in 62.5% of extrauterine pregnancies
and in 31.3% of intrauterine pregnancies, and these cells consisted of actively
secreting cells, that might perform cheifly apocrine secretion.
6. The large queantity of ribonucleic acid granules which were observed diffusely
in the cytoplasm if epithelial cells in the proliferative and hyperplastic
endometria was interpreted
as an index of active protein synthesis in these conditions, and those which
concentrated above or near the nuclei or the epithelial cells seemed to concern the
secretory function in secretory and pregnant endometria.
7. The cyclicity of the alkaline phosphatase activity was well domenstrated in
the cell membrane of the epithelium, whereas the enzymatic activity in the blood
vessels did not show the cyclic change. In the proliferative endometrium the
epithelial activity was higher than in the secretory or pregnant endometrium but
those in hyperplasia and adenocarcinoma were various from gland to gland, or from
cell to cell.
8. The estrogen was considered to contribute more to the development of
hyperplasia and adenocarcinoma than the progesterone because the histochemical
findings of these abnormal conditions were more or less similar to those of
proliferative endometrium, although irregular findings were also noted in
hyperplasia or adenocarcinoma.
[영문]
The endometrium undergoes marked morphelogic and functional changes in a vey short period of time, and these are controlled by overian hormones. These changes of the endometrium ar fundamentally based on the biochemical alterations. The
endometrium is composed of surface and glandular epithelium, connective tissue, and blood vessels, all of which participate in the morphologic alteration during the cyclic changes, Thus, to understand the mechanisms of morphologic alterations and the basis of endometrial function, histochemical studies concerning the localisation of specific chemical and enzymatic activity are very important (Mckay, et al.,1956**a ; Levine, 1963).
It is the purpose of this report (1) to evaluate histochemical patterns during the normal cyclic processes of the endometrium, and (2) to search for the histochemical differences in various conditions of endometrium from that of normal endometrium.
Material and Methods
Ninety endometris curetted from normal and abnormal uteri were obtained from the Department of Obstetrics and Gynecology, Severance Hospital. The histologic criteria of Noyes, et al. (1951) were used to establishthe state of each specimen.
Of the 25 normal specimens, 9 were proliferative, 14 were secretory, and 2 were menstrual. And the 65 abnormal endometria consisted of 16 with intrauterine pregnancies, 16 with extrauterine pregnancien, 25 with hyperplasia, 3 with atypical
hyperplasia, 3 with adenocarcinoma, and 2 with endometrial polyp. A portion of each specimen was frozen-sectioned and prepared for the activity of alkaline phosphatase by Gomori's metal-salt method (1939).
The remainder of each specimen was fixed in 10% neutral formalin solution. The paraffin-embedded sections were stained by hematoxylin and eosin, periodic acid-Schiff reachtion for glycogen and glycoprotein, alcian blue stain for acid
mucopolysaccharides, and methylgreen pyronin stain for ribonucleic acid.
Results and Summary
1. The PAS positive material, regarded as glycogen or glycoprotein, underwent the cyclic changes in surface as well as glandular epithlium of the normal endometrium; the amount of the material was greater in the sectetory endometrium than in the
proliferative endometrium and was also large in the endometria of intra-as well as extrauterine pregnancies. But in hyperplasia and adenocarcinoma, the PAS positive material was small in amount like in the proliferative endometrium.
2. The acid mucopolysaccharides which were located chiefly along the brush border of epithelium and in the stroma, reealed its cyclicity, and increased in the secretory endometrium.
3. It was an interesting finding that diffuse intracyto-plasmic location of acid mucopolysaccharides was observed only in hyperplastic and cancerous endometria.
4. No significant histochemical differences were found in the endometria between intra-and extrauterine pregnancies.
5. The Arias-Stella atypias were observed in 62.5% of extrauterine pregnancies and in 31.3% of intrauterine pregnancies, and these cells consisted of actively secreting cells, that might perform cheifly apocrine secretion.
6. The large queantity of ribonucleic acid granules which were observed diffusely in the cytoplasm if epithelial cells in the proliferative and hyperplastic endometria was interpreted
as an index of active protein synthesis in these conditions, and those which concentrated above or near the nuclei or the epithelial cells seemed to concern the secretory function in secretory and pregnant endometria.
7. The cyclicity of the alkaline phosphatase activity was well domenstrated in the cell membrane of the epithelium, whereas the enzymatic activity in the blood vessels did not show the cyclic change. In the proliferative endometrium the epithelial activity was higher than in the secretory or pregnant endometrium but
those in hyperplasia and adenocarcinoma were various from gland to gland, or from cell to cell.
8. The estrogen was considered to contribute more to the development of hyperplasia and adenocarcinoma than the progesterone because the histochemical findings of these abnormal conditions were more or less similar to those of proliferative endometrium, although irregular findings were also noted in