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.
OBJECTIVE
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.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
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).


METHODS
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Machado
Daniel Escorsim
DE
Department of Histology and Embryology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Abrao
Maurício Simões
MS
Berardo
Plínio Tostes
PT
Takiya
Christina Maeda
CM
Nasciutti
Luiz Eurico
LE
D000328:Adult; D002196:Capillaries / Q000737:chemistry; D016022:Case-Control Studies; D004715:Endometriosis / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009389:Neovascularization, Pathologic / Q000378:metabolism* / Q000473:pathology; D010049:Ovarian Diseases / Q000378:metabolism* / Q000473:pathology; D010053:Ovary / Q000737:chemistry; D011446:Prospective Studies; D012002:Rectal Diseases / Q000378:metabolism* / Q000473:pathology; D012007:Rectum / Q000737:chemistry; D001743:Urinary Bladder / Q000737:chemistry; D001745:Urinary Bladder Diseases / Q000378:metabolism* / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000032:analysis*; D014841:von Willebrand Factor / Q000032:analysis
C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D014841:von Willebrand Factor; D040301:Vascular Endothelial Growth Factor Receptor-2