title: Decorin expression with stump recurrence and neovascularization after varicose vein surgery--a pilot study.
abstract: BACKGROUND
  An evaluation of the reason for saphenofemoral recurrence (SFR, technical error vs neovascularization) after surgery is necessary to improve the method or find purchase for new therapies. Currently, differentiation by the surgeon or ultrasound are unsatisfying; histology depends mainly on the physician's experience. Decorin, an extracellular matrix component, is up-regulated in angiogenesis with antiangiogenetic effects on neovascularization.
  
  
  OBJECTIVE
  To determine whether decorin is a reliable marker to distinguish neovascularization and stump recurrence.
  
  
  METHODS
  Twenty specimens obtained in re-operation of patients with duplex-detected SFR were stained with hematoxylin and eosin, Elastica van Gieson, and decorin antibody. An experienced pathologist reviewed specimens for stump recurrence or neovascularization. An independent physician analyzed the specimens semiquantitatively for expression of decorin (0=none to 3=strong).
  
  
  RESULTS
  Only low expression of decorin was found around residual stumps (1.4±0.5), but extensive expression was detectable around neovascularization (2.4±0.3, p=.001). In one specimen with neovascularization and a residual stump, decorin was a capable marker to divide the two zones. Correlation of histological and decorin-based diagnosis was 100%, but differentiation was much easier with decorin.
  
  
  CONCLUSIONS
  Decorin is a marker for any easy differentiation of stump recurrence and neovascularization and can support further investigation in SFR and improvement of the primary therapy.
authors.affiliation: Vein Centre, Department of Dermatology, Hiltroper Landwehr, Bochum, Germany. stefanie.reich-schupke@rub.de
authors.forename: Stefanie
authors.initials: S
authors.lastname: Reich-Schupke
authors.forename: Achim
authors.initials: A
authors.lastname: Mumme
authors.forename: Peter
authors.initials: P
authors.lastname: Altmeyer
authors.forename: Markus
authors.initials: M
authors.lastname: Stuecker
mesh_terms: D058575:Decorin / Q000096:biosynthesis*; D006801:Humans; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D010865:Pilot Projects; D012008:Recurrence; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*
chemical_list: D058575:Decorin