ANÁLISE DO POLIMORFISMO DO GENE P53 EM PACIENTES COM CLÍNICA DE ENDOMETRIOSE ASSOCIADO À INFERTILIDADE

Abstract

Endometriosis it is considered as the presence of ectopic endometrial tissue, with similar histology and function to the endometrium usually located. However, the explanation for the implantation of the endometrial tissue in certain women is still unknown. The determination of the degree of compromising of the endometriosis is based on a system of points proposed by American Fertility Society finds of the laparoscopy. Endometriosis is a disease that occurs mainly in women in reproductive age. The disease can be related with infertility in 30% to 40% of the cases. The possible mechanisms as the endometriosis as cause of the infertility are: (a) interference with the sexual function (dyspareunia, reduction of the frequency of sexual intercourse). (b) Interference with the ovulation: (anovulation; deficient luteal phase and luteinization phase. The aim of this study was to determine the frequency of p53 polymorphism codon 72, in two groups of patients with endometriosis and other symptoms of the disease. The study included 38 peripheral blood samples from women submitted to videolaparoscopy that confirmed endometriosis. The patients were divided into two groups of 19 women each, one with infertility and the other not. The polymorphism was evaluated by PCR. The data were submitted to statistical analysis using the chi-square and odds ratio tests. Of the patients who only had pain and/or bleeding without infertility, 09 (47.3%) were arginine homozygous and 10 (52.6%) were proline homozygote or heterozygote. Of those who presented with infertility associated with pain and/or bleeding, 12 (100%) were proline homozygous or heterozygous, and in those with only complaint of infertility, 05 (71.4%) were arginine homozygous and 02 (28.6%) proline homozygous or heterozygous). In correlating pain intensity, 04 (23.5%) women with the proline allele (homozygous or heterozygous) reported slight or moderate pain and 20 (95.5%) intense pain. All these differences were statistically significant (p= 0.003). In relating pain intensity to laparoscopic classification, the following was found: 08 (50%) patients who showed slight or moderate pain had a classification I or II and 08 (50%) III or IV. Of those with intense pelvic pain, 08 (36.4%) were included in classification I or II and 14 (63.6%) in III or IV. The proline allele (homozygous or heterozygous) is linked more to patients with infertility and with a more severe clinical picture.