Andrikopoulou Maria, Chatzistamou Ioulia, Gkilas Harry, Vilaras George, Sklavounou Alexandra
Clinic of Gynecology and Obstetrics, Aretaieion Hospital, Medical School of Athens, Athens, Greece.
J Oral Maxillofac Surg. 2013 Aug;71(8):1376-81. doi: 10.1016/j.joms.2013.03.009. Epub 2013 Apr 24.
Oral pregnancy tumors (OPTs) arise on the inflamed gingiva of women after the first trimester of pregnancy. The expression of angiogenic markers and female hormone receptors was assessed.
Immunohistochemistry was used to analyze the expression of estrogen and progesterone receptors and the expression of angiogenic factors, such as vascular endothelial growth factor (VEGF) and its receptor, fibroblast growth factor (FGF), and hypoxia inducible factors 1α and 3α (HIF1α and HIF3α). Experimental groups included 9 OPTs, 10 oral pyogenic granulomas from nonpregnant women of the same age, and 9 oral pyogenic granulomas from postmenopausal women.
VEGF expression in stromal histiocytes and endothelial cells of small vessels was positively correlated in the OPT group (P < .05 by χ(2) test). VEGF receptor also was overexpressed in stromal histiocytes and endothelial cells of OPTs compared with oral pyogenic granulomas from nonpregnant and postmenopausal women (P < .005 by χ(2) test). No correlation was detected among estrogen and progesterone receptors, FGF and HIF1α and HIF3α (ER and PgR respectively) in the 3 experimental groups.
VEGF-associated angiogenesis is most likely involved in the pathogenesis of the lesion. These results imply that local inhibition of VEGF activity could be an adjuvant therapeutic approach for OPTs to control hemorrhage, which can be massive at the surgical excision of such lesions during pregnancy.
口腔妊娠瘤(OPT)出现在妊娠前三个月后女性的炎症牙龈上。评估血管生成标志物和女性激素受体的表达。
采用免疫组织化学分析雌激素和孕激素受体的表达以及血管生成因子的表达,如血管内皮生长因子(VEGF)及其受体、成纤维细胞生长因子(FGF)、缺氧诱导因子1α和3α(HIF1α和HIF3α)。实验组包括9例口腔妊娠瘤、10例来自同年龄非妊娠女性的口腔化脓性肉芽肿以及9例绝经后女性的口腔化脓性肉芽肿。
口腔妊娠瘤组中小血管的基质组织细胞和内皮细胞中的VEGF表达呈正相关(χ²检验,P <.05)。与非妊娠和绝经后女性的口腔化脓性肉芽肿相比,口腔妊娠瘤的基质组织细胞和内皮细胞中VEGF受体也过度表达(χ²检验,P <.005)。在3个实验组中,未检测到雌激素和孕激素受体、FGF与HIF1α和HIF3α(分别为ER和PgR)之间的相关性。
VEGF相关的血管生成很可能参与了该病变的发病机制。这些结果表明,局部抑制VEGF活性可能是口腔妊娠瘤控制出血的辅助治疗方法,在妊娠期手术切除此类病变时出血可能很严重。