Aitken E, Khaund A, Hamid S A, Millan D, Campbell S
Division of Developmental Medicine, University of Glasgow, Glasgow Royal Infirmary, Department of Pathology, North Glasgow Hospitals Trust, UK.
Hum Reprod. 2006 Oct;21(10):2669-78. doi: 10.1093/humrep/del220. Epub 2006 Jun 28.
The human uterine vasculature is highly structured, exhibiting circumferential and radial branching. Previously published angiograms of the arterial network describe a system of regular coils. Uterine fibroids lack this structured vasculature. In this study, we make a comparison between the vasculature in normal myometrium and in fibroids using robust stereological methods thus far lacking in the literature.
Stereological and morphometric analysis of the vascular system was carried out on 15 normal and 27 small fibroid (5-40 mm) uteri taken from women suffering menorrhagia. Projected images of published angiograms were also re-examined, measuring tortuosity.
A decreasing gradient of vascular smooth muscle from outer to inner myometrium was found in normal uteri, with no corresponding gradient in capillary tissue fraction. An association between vascular luminal size, amplitude and frequency of vessel bending was also established. Conversely, fibroids were found to lack structured or muscularized vasculature.
A quantitative gradient within the myometrial vascular system, which is absent in fibroids, has been demonstrated. These structural differences between diseased and healthy tissues are probably because of differing expression of angiogenic growth factors and may explain the distribution of particles seen after uterine artery embolization.
人类子宫血管系统结构高度复杂，呈现出环向和径向分支。先前发表的动脉网络血管造影显示出一个规则的盘绕系统。子宫肌瘤缺乏这种结构化的血管系统。在本研究中，我们使用文献中迄今缺乏的可靠体视学方法，对正常子宫肌层和肌瘤中的血管系统进行比较。
对15例正常子宫和27例来自月经过多女性的小肌瘤（5 - 40毫米）子宫进行血管系统的体视学和形态学分析。还重新检查了已发表血管造影的投影图像，测量其曲折度。
在正常子宫中发现从外层到内层子宫肌层的血管平滑肌呈递减梯度，而毛细血管组织分数无相应梯度。还建立了血管腔大小、血管弯曲幅度和频率之间的关联。相反，发现肌瘤缺乏结构化或肌化的血管系统。
已证明子宫肌层血管系统内存在定量梯度，而肌瘤中不存在。病变组织和健康组织之间的这些结构差异可能是由于血管生成生长因子的不同表达，并且可能解释了子宫动脉栓塞后所见颗粒的分布。
