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Purpose  To investigate the expression of annexin A2 (ANXA2) in ectopic and eutopic endometrium and serum of women with adenomyosis, and their relationships with adenomyosis-associated dysmenorrhea.    Methods  The expression of ANXA2 was detected by immunohistochemical S-P method in ectopic and eutopic endometrium tissues from 30 patients with adenomyosis who underwent hysterectomy. The correlation between ANXA2 expression and dysmenorrhea degree was evaluated. The endometrium tissues from 15 patients with uterine fibroids which underwent hysterectomy were used as controls. The preoperative serum level of ANXA2 was measured by enzyme-linked immunosorbent assay in 30 patients with adenomyosis and 15 patients with hysteromyoma.    Result  The expression of ANXA2 in eutopic and ectopic endometrium of adenomyosis was higher than in normal endometrium ( P  < 0.05), but no significant difference of ANXA2 expression was observed between the eutopic endometrium and the ectopic endometrium ( P  > 0.05). In the ectopic endometrium, but not in the eutopic endometrium, of women with adenomyosis, ANXA2 expression was positively correlated with the severity of dysmenorrhea ( R  = 0.831,  P  = 0.000). The preoperative serum level of ANXA2 was markedly higher in patients with adenomyosis compared with the patients with hysteromyoma ( P  < 0.05).    Conclusion  The increased ANXA2 may contribute to the occurrence and development of adenomyosis, and may play a important role in the dysmenorrhea. The present study may provide a new idea of diagnosis and treatment to adenomyosis-associated dysmenorrhea.

Expression of annexin A2 in adenomyosis and dysmenorrhea