The Expression Of VEGF And ICAM-1 In Endometriosis

Endometriosis is a common gynecologic disease. Its incidence in women of reproductive age is 15% and its pathogenesis is still unclear. Up to now, the hypothesis of endometrium exfoliative fragments transplantation which Sampson put forward in 1925 has been accepted by most scholars. The feature of ectopic endometrium is similar to malignant tumor. Invasion is a complicated process in which many factors participate, and it mainly includes three stages: adhesion, angiogenesis and implantation. Adhesion molecule, some enzymes and vascular growth factor (VEGF) are likely to be involved in this process. It is essential for the retrograde fragments of endometrium to peritoneal cavity during the menstruation to attach to the peritoneal layer. Adhesion molecules regulate the interaction of cells with extracellular matrix and/or other cells. Theintercellular adhesion molecule-1 (ICAM-1; CD54) is one member of the immunoglobulin superfamily. Many studies show that abnormal expression of ICAM-1 may play a key role in the implantation, adhesion and development of endometriosis. After the exfoliated endometrium attaches to the peritoneal layer, the establishment of new and adequate blood supply is essential for the survial of the endometrial implant and development of endometriosis. So angiogenesis play an important role in the process of endometriosis. VEGF is an important angiogenesis stimulator of the known angiogenic factors. Many studies show that the fluid from the peritoneal cavity of patients with endometriosis contains significantly greater amounts of VEGF than that from control group. It indicates that elevating angiogenic activity of VEGF increases endometrium angiogenesis and plays an important role in endometriosis. The purpose of this study is to investigate the relationship between intracellular adhesion molecule- 1 (ICAM-1), VEGF and endometriosis, especially the expression of ICAM-1 and VEGF in ectopic endometrium and to study the role of VEGF, ICAM-1 in endometriosis development.Methods: 34 specimens of ectopic endometrium, 30 specimens of eutopic endometrium with endometriosis and 31 specimens with normal endometrium come from hysterectomy. All specimens were fixed in formalin, embedded in paraffin and stained by hematoxylinesoin. All diagnoses of specimens were confirmed by histopathology. The expression of VEGF and ICAM-1 were detected by immunohistochemical S-P methods.Results:1. Expression of ICAM-1: ICAM-1 positive substance was located mainly in the cellular plasma. The positive rate of ICAM-1 in normal endometrium was 35.48%. whereas 10.00% in eutopic endometrium, 61.77% in ectopic endometrium of endometriosis. The positive rate in ectopic endometrium group was higher than that in normal endometrium group (p<0.05). There was also obvious difference between eutopic endometrium group and normal endometrium group (p<0.05).2. Expression of VEGF: VEGF positive substances were located mainly in the celluar plasma. The VEGF was not detected in normal endometrium. The positive rate of VEGF in ectopic endometrium was 73.53%, whereas 33.33% in eutopic endometrium. The positive rate of ectopic endometrium group was significantly higher than that of normal endometrium group (p<0.001). The positive rate in ectopic endometrium group was higher than that in eutopic endometrium group (p<0.01). There was obvious difference between eutopic endometrium group and normal endometrium group (p<0.01).Conclusions:1. Because of lower ICAM-1 protein expression in eutopic endometrium with endometriosis, lower of stability and adhesive ability could easily transplant to peritoneal cavity. ICAM-1 is a significant factor which involved in the pathogenesis and development of endometriosis.2.The expression rate of VEGF in ectopic endometrium is higher than in that ofeutopic endometrium, but there is no expression of VEGF in normal endometrium. It indicates VEGF play a pivotal role in the development of endometriosis.3. The patients with ICAM-1 in lower...