title: 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.
abstract: 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.
authors.affiliation: Department of Histology and Embryology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Daniel Escorsim
authors.initials: DE
authors.lastname: Machado
authors.forename: Maurício Simões
authors.initials: MS
authors.lastname: Abrao
authors.forename: Plínio Tostes
authors.initials: PT
authors.lastname: Berardo
authors.forename: Christina Maeda
authors.initials: CM
authors.lastname: Takiya
authors.forename: Luiz Eurico
authors.initials: LE
authors.lastname: Nasciutti
mesh_terms: 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
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D014841:von Willebrand Factor; D040301:Vascular Endothelial Growth Factor Receptor-2