Biochemical parameters of abnormal endometrium

Normal and abnormal endometrial tissues have been studied by histologic, histochemical, and biochemical methods. The effect of ovarian steroids upon these tissues has been observed in organ culture. It is apparent that abnormal endometrial tissue, namely, endometrium obtained from women over 40 yr of age with excessive uterine bleeding and classified as proliferative, hyperplastic, or with adenomatous carcinoma, has lost its cyclicity and remained in the proliferative state. In this respect, the tissue-synthetized glycogen in steady amounts fail to reach a peak concentration at any time. Synthetase activity was increased when the endometrium remained in the proliferative phase while phosphorylase activity was decreased in all forms of abnormal endometrium. Likewise, enzyme activity, namely, glucose-6-phosphatase and alkaline phosphatase, was decreased in the abnormal tissue thereby encouraging retention of glycogen rather than releasing the glycogen, a function carried on in normal endometrium after ovulation if conception does not take place. This retention of glycogen in constant amounts in the abnormal tissue suggests that carbohydrate metabolism changes from one of glycogen deposition and release to conversion into the production of cellular energy by the abnormal proliferating cells. The activity of the enzymes of the Krebs' cycle and hexose shunt, as measured by their respective enzyme activity, are increased in abnormal endometrium and may be strong factors in the conversion of retained glycogen into energy and cellular proliferation. Addition of estradiol in organ culture containing normal and abnormal endometrial tissue increased cellular proliferation while the addition of progesterone increased the synthesis of glycogen from glucose in significant amounts.