Machado Daniel Escorsim, Abrao Maurício Simões, Berardo Plínio Tostes, Takiya Christina Maeda, Nasciutti Luiz Eurico
Department of Histology and Embryology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Fertil Steril. 2008 Jul;90(1):148-55. doi: 10.1016/j.fertnstert.2007.05.076. Epub 2007 Sep 4.
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.
Prospective study.
University hospital.
PATIENT(S): Thirty women with endometriosis (10 ovarian, 10 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.
分析血管生成素血管内皮生长因子（VEGF）及其受体Flk-1在增殖期和分泌期人正常子宫内膜以及子宫内膜异位症三个不同部位（卵巢、膀胱和直肠）中的血管密度和免疫定位。
前瞻性研究。
大学医院。
30例子宫内膜异位症患者（10例卵巢型、10例膀胱型、10例直肠型）和32例对照女性（10例增殖期子宫内膜、10例分泌期子宫内膜、4例正常卵巢、4例正常膀胱、4例正常直肠）。
正常子宫内膜样本取自接受腹腔镜下浆膜下肌瘤切除术的女性，子宫内膜异位症活检标本取自接受子宫内膜异位症诊断和治疗手术的患者。卵巢、膀胱和直肠的正常组织取自子宫内膜异位症病变旁的这些器官。
根据血管性血友病因子阳性内皮细胞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。
与相应对照样本和正常子宫内膜相比，子宫内膜异位症患者，尤其是直肠子宫内膜异位症患者，血管更多，且血管位于腺体周围的子宫内膜间质中。子宫内膜异位症患者，尤其是直肠子宫内膜异位症患者，VEGF和Flk-1的表达水平也更高。
在累及直肠的深部浸润性子宫内膜异位症中，血管生成以及VEGF和Flk-1的表达显著更高，这强化了抗血管生成治疗可能构成一种新的治疗方式的假说，尤其是在累及直肠的深部子宫内膜异位症病例中。
