Vascular density and distribution of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2 (Flk-1) are significantly higher in patients with deeply infiltrating endometriosis affecting the rectum
Vascular density and distribution of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2 (Flk-1) are significantly higher in patients with deeply infiltrating endometriosis affecting the rectum
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DOI：
10.1016/j.fertnstert.2007.05.076
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发表时间：
2008-07-01
影响因子：
6.7
通讯作者：
Nasciutti, Luiz Eurico
中科院分区：
文献类型：
--
作者：
Machado, Daniel Escorsim;Abrao, Mauricio Simoes;Nasciutti, Luiz Eurico
目的：分析增殖和分泌性在位人子宫内膜中血管密度和血管内皮生长因子（VEGF）及其受体Flk-1的免疫定位。以及子宫内膜异位症的三个不同部位：卵巢、膀胱和直肠。设计：前瞻性研究。地点：大学医院。患者：30 名患有子宫内膜异位症的女性（10 名卵巢、1.0 名膀胱、10 名直肠）和 32 名对照女性（10 名增殖性子宫内膜、10 名分泌性子宫内膜、4 名正常卵巢、4 名正常膀胱、4 名正常干预措施：正常子宫内膜样本取自腹腔镜浆膜下肌瘤消融术中的女性，子宫内膜异位症活检标本取自接受手术的患者，以诊断和治疗子宫内膜异位症。取子宫内膜异位病灶旁的卵巢、膀胱、直肠正常组织。主要指标(S)：根据血管性血友病因子阳性内皮细胞的数量对血管进行定量。通过免疫组织化学染色半定量评估 VEGF 和 Flk-1 的分布。 结果：与各自的对照样本和在位子宫内膜相比，子宫内膜异位症，特别是直肠子宫内膜异位症病例中发现更多血管，并且它们位于腺体周围的子宫内膜间质中。子宫内膜异位症，尤其是直肠子宫内膜异位症中，VEGF 和 Flk-1 的表达水平也较高。结论：在影响直肠的深部浸润子宫内膜异位症中，血管化以及 VEGF 和 Flk-1 的表达显着升高，这强化了抗血管生成治疗可能构成新的治疗方式的假设，特别是在累及直肠的深部子宫内膜异位症的情况下。
Objective: To analyze vascular density and immunolocalization of angiogenic vascular endothelial growth factor (VEGF) and its receptor Flk-1 in the proliferative and secretory eutopic human endometrium. and in three different sites of endometriosis: the ovary, bladder, and rectum.Design: Prospective study.Setting: University hospital.Patient(s): Thirty women with endometriosis (10 ovarian, 1.0 bladder, 10 rectal) and 32 control women (10 proliferative endometrium, 10 secretory endometrium, 4 normal ovary, 4 normal bladder, 4 normal rectum).Intervention(s): Normal endometrial samples were obtained from women during laparoscopic ablation of subserous myoma, and biopsy specimens of endometriosis were obtained from patients undergoing surgery for the diagnosis and treatment of endometriosis. Normal tissues of ovary, bladder, and rectum were obtained from these organs beside the lesions of endometriosis.Main Outcome Measure(S): Blood vessels were quantified according to the number of von Willebrand factor-positive endothelial cells. The VEGF and Flk-1 distribution were evaluated semiquantitatively by immunohistochemical staining.Result(s): More blood vessels were found in cases of endometriosis, particularly rectal endometriosis, compared with the respective control samples and with the eutopic endometrium, and they were localized in endometrial stroma around the glands. The VEGF and Flk-1 expression levels were also higher in cases of endometriosis, especially rectal endometriosis.Conclusion(s): Vascularization and VEGF and Flk-1 expression are significantly higher in deeply infiltrating endometriosis affecting the rectum, reinforcing the hypothesis that antiangiogenesis therapy may constitute a new modality of treatment, especially in cases of deep endometriosis involving the rectum.