Immunohistochemical analysis of vascular endothelial growth factor cellular expression in ovarian endometriomata.

OBJECTIVE

To evaluate the expression of vascular endothelial growth factor (VEGF) in the cell populations of ovarian endometriomata cyst layers.

DESIGN

Experimental retrospective study.

SETTING

University hospital.

PATIENT(S): Twenty-eight patients with ovarian endometriomata.

INTERVENTION(S): Surgical excision of 32 ovarian cysts.

MAIN OUTCOME MEASURE(S): Histologic and VEGF immunohistochemical analysis of cyst layers.

RESULT(S): Though the least represented cell types, macrophages exhibited the highest frequency of strong immunoreactivity, followed by capsular vessel endothelial and subepithelial stromal cells and by epithelial cells and capsular fibroblasts. Endothelia of the subepithelial stroma were the least immunoreactive cells. Diffuse VEGF expression in epithelial cells was associated with cyst diameters greater than 5.4 cm, and high VEGF expression in capsular fibroblasts was associated with bilateral cysts.

CONCLUSION(S): Angiogenesis plays an active role in ovarian endometriosis, especially in the presence of large and bilateral cysts. Expression of VEGF in epithelial cells, capsular fibroblasts, and vessels was found to be related, suggesting that neoangiogenesis might especially affect the outer cyst wall, thus contributing to the fibrosing process of adhesion formation during cyst growth.