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

Daniel Escorsim Machado, Machado DE, Abrao MS, Maurício Simões Abrao, Maurício Simões Abrão, Berardo PT, Plínio Tostes Berardo, Christina Maeda Takiya, Nasciutti LE, Luiz Eurico Nasciutti
Fertility and sterility · 2007 · vol. 90(1) , pp. 148–155 · doi:10.1016/j.fertnstert.2007.05.076 · PMID:17765237 · W2093999544
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Deeply infiltrating endometriosis affecting the rectum is characterized by significantly higher vascular density and increased expression of VEGF and VEGFR-2.

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Abstract

ObjectiveTo 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.DesignProspective study.SettingUniversity 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.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Neovascularization, Pathologic Ovarian Diseases Rectal Diseases Urinary Bladder Diseases Vascular Endothelial Growth Factor A Vascular Endothelial Growth Factor Receptor-2 Adult Capillaries Capillaries Case-Control Studies Endometriosis Endometriosis Female Humans Immunohistochemistry Neovascularization, Pathologic Neovascularization, Pathologic Ovarian Diseases Ovarian Diseases

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