title: Haemorrhoids are related to changes of cell function in mucosa and submucosa.
abstract: OBJECTIVE
  Epidemiology and risk factors of haemorrhoidal disease are not well defined. This study tried to evaluate if the appearance of haemorrhoids is related to a disturbed remodelling of the soft tissue of rectal mucosa and submucosa. Therefore, immunohistochemical expression profiles of five parameters as potential mediators in neoangiogenesis (EGFR), in inflammatory cell activity (COX-2), and in cell migration, differentiation, and wound healing (notch-3, c-myc, and beta-Catenin) were analysed (Saed et al., Fertil Steril 83(Suppl 1):1216-1219, 1; Saed et al., Fertil Steril 79:1404-1408, 2; Stojadinovic et al., Am J Pathol 167:59-69, 3).
  
  
  METHODS
  Haemorrhoidal tissue specimens were collected from 44 patients. Healthy rectal mucosa was obtained from 16 non-fixed fresh cadavers and served as control. Histological and immunohistochemical markers like EGFR, COX-2, notch-3, c-myc, and beta-Catenin were analysed semi-quantitatively, separately for mucosal and submucosal layer.
  
  
  RESULTS
  Significantly increased expressions were found for EGFR, COX-2, and notch-3 in the mucosal and submucosal layer of haemorrhoidal tissue in comparison to normal rectal tissue.
  
  
  CONCLUSIONS
  This finding confirms that haemorrhoidal disease may be regarded as a manifestation of a soft tissue disease.
authors: Department of Surgery, RWTH Aachen University Hospital, Aachen, Germany. cklink@ukaachen.de
authors: Christian
authors: C
authors: Klink
authors: Marcel
authors: M
authors: Binnebösel
authors: Daniel
authors: D
authors: Kämmer
authors: Stefan
authors: S
authors: Willis
authors: Andreas
authors: A
authors: Prescher
authors: Uwe
authors: U
authors: Klinge
authors: Volker
authors: V
authors: Schumpelick
mesh_terms: D000368:Aged; D051546:Cyclooxygenase 2 / Q000378:metabolism; D066246:ErbB Receptors / Q000378:metabolism; D006484:Hemorrhoids / Q000201:enzymology / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology*; D051880:Receptors, Notch / Q000378:metabolism; D051176:beta Catenin / Q000378:metabolism
chemical_list: D051880:Receptors, Notch; D051176:beta Catenin; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D066246:ErbB Receptors