Expression Of Vascular Endothelial Growth Factor And Kerotinocyte Growth Factor In Adenomyosis

Objective: To investigate the expression of Vascular Endothelial Growth Factor (VEGF) and Kerotinocyte Growth Factor(KGF) in adenomyosis and their implications.Methods: The subjects were devided into two groups: eutopic and ectopic endometrium were obtained from 30 patients with histologically proven adenomyosis, 12 in the proliferative phase and 18 in the secretive phase. Using immunohistochemical method with specific polycolonal antibodies, formalin fixed paraffin sections of the tissues were stained for VEGF and KGF.Results: 1. VEGF expression VEGF protein expressed mainly in glandular cells and endothelial cells, and the expression diffused in the stromal cells. (1) glandular expression The expression of normal glandular cells was higher in secretive phase than in proliferative phase.(P<0.05) But there was no significant change in the adenomyosis(P>0.05). In the proliferative phase, the expression of normal,eutopic and ectopic glandular cells significantly increased orderly(P<0.01,P<0.05). During the secretive phase, ectopic glandular cells expressed higher VEGF than eutopic and normal endometrium (P<0.01), butthere was no difference between eutopic and normal endometrium(P>0.05). In the secretive phase, the percentile of strongly positive cases was 65% in the ectopic glandular cells, and the percentile was 33% in the eutopic endometrium. The normal glandular cells were all positive or weakly positive.2. KGF (1) stromal expression In the stromal cells, the endometrial phase had no influence on KGF in the endometrium of control and adenomyosis(P>0.05). Therefore, the results were evaluated regardless of the menstrual cycle. Eutopic and ectopic endometrium expressed higher KGF protein than in normal endometrium (P<0.01). The percentile of strongly positive cases was 54% in the ectopic stromal cells, whereas eutopic expressed 30%. The normal stromal cells were all posotive or weakly positive. (2) glandular expression hi the glandular cells, the normal endometrium stained significantly higher in proliferative phase than in secretary phase(P<0.05), whereas there were no cyclic changes in adenomyosis (P>0.05). During the proliferative phase, ectopic endometrium stained stronger than control (P<0.01). During the secretary phase, the stain of normal, eutopic and ectopic endometrium significantly increased orderly(P<0.01,P<0.05). All the ectopic cases were positive or strongly positive, and the control group were almost weakly positive or positive.Conclusions:l.The fact that there were no cyclicchanges in adenomyosis reflected the disturbance of hormone regulation, or the insensitive of adenomyotic tissues to the ovarial hormone. That may explain the inefficient drug therapy for adenomyosis, 2.The increasing of angiogenesis resulted from the high VEGF expression may relate to some clinical symptoms such as menorrahia, and biophysical property such as invading growth. 3. In the adenomyosis, stromal cells expressed high KGF than normal control, glandular cells stained deeper than normal. These may result proliferative property of adenomyotic glandular, and may inhance the metastasis ability of endometrium and lead to the onset of this disease. 4. There were sameness and differences between eutopic and ectopic endometrium, it is difficult to tell if the ectopic endometrium derived from eutopic endometrium. 5. The co-action of glandular and stromal tissues may pay an important role in the pathogenesis of adenomyosis.