Expression And Significance Of VEGF And Its Receptor KDR In Ovarian Endometriosis

Objective To detect the expression of vascular endothelial growth factor(VEGF) and its corresponding kinase insert domain receptor(KDR) in eutopic endometrium and ovarian ectopic endometrium and its surrounding ovarian tissue with ovarian endometriosis(OEM).The aim of our study was to discuss their role of pathogenesis in endometriosis angiogenesis.Methods Using immunohistochemical S-P techonology,the expression of VEGF and KDR and CD34(using for marking microvessel) was examined and compared in the tissue of ovarian ectopic endometrium(44 biopsy specimens),ovarian tissue surrouding ovarian ectopic endometrium(44 biopsy specimens) and eutopic proliferative endometrium(20 biopsy specimens) respectively which were from 51 women patients with OEM(stageⅡ～Ⅲ,R-AFS 1985) enrolled for this study undergoing laparotomy and laparoscopy and diagnosed clearly through pathology who were initial diagnosed and treated,compared with their expression in the proliferative eutopic endometrium of the menstrual cycle from women without endometriosis(18 biopsy specimens). According to the aim of our study,the subjects were assigned into four groups: (group A-C) biopsy specimens from women with OEM:(group A) ovarian ectopic endometrium(44 biopsy specimens),(group B) ovarian tissue surrouding ovarian ectopic endometrium from group A(44 biopsy specimens),(group C) eutopic endometrium(20 biopsy specimens);group D was eutopic proliferative endometrium without endometriosis(18 biopsy specimens).Results①VEGF and its corresponding receptor KDR were mainly located in the cytoplasm of gland epidermis in eutopic and ectopic endometrium,while CD34 used for marking microvessel was mainly located in the vessel endothelium cell.②The positive immunostaining rates of VEGF and KDR proteins in group A were 63.6%,54.6% respectively,while the rates in group B were only 6.8%,15.9%respectively.The positive immunostaining rates of VEGF and KDR proteins in ectopic endometrium were both significantly higher than those in ovarian tissue surrounding ectopic endometrium(P＜0.01).And their synchro expression in ectopic endometrium and eutopic endometrium was positive relative relationship(P＜0.01).③The positive immunostaining rates of VEGF and KDR proteins in group C were 80.0%,75.0% respectively,while the corresponding rates in group D were 16.7%,27.8% respectively.The difference of VEGF and KDR expression in eutopic endometrium with endometriosis compared with that without endometriosis was significant(P＜0.01).④The MVD in ectopic endometrium with OEM was 184.1±34.9/mm~2 and that in eutopic endometrium with the same patients was 185.9±43.1/mm~2 and the difference was not significant(P＞0.05).While the MVD in eutopic endometrium without endometriosis was 155.2±37.6/mm2,the MVD in eutopic endometrium with OEM was higher than that in eutopic endometrium without endometriosis and the difference was significant(P＜0.05).MVD was little in ovarian tissue surrouding ovarian ectopic endometrium.The positive immunostaining rates of VEGF and KDR with high MVD in ovarian ectopic endometrium(＞184.1/mm2) were both higher than that with low MVD(＜184.1 /mm2) and both of them were well corrected with MVD(P＜0.05).Conclusions①The expression of VEGF and KDR in ectopic endometrium tissue with high concentration of MVD was significantly higher than that in neighboring ovarian tissue.Therefore their synchro expression might be relative to angiogenesis in ovarian endometriosis.②The expression of VEGF and its corresponding receptor KDR and MVD in eutopic endometrium tissue with endometriosis was significantly higher than that in eutopic endometrium tissue without endometriosis.At the same time the expression of them in ectopic and eutopic endometrium with endometriosis was similar,which supported the theory "determinant of uterine eutopic endometrium".③The positive immunostaining rates of VEGF and KDR proteins with high MVD in ectopic endometrium were both higher than that with low MVD and they were both well corrected with MVD,which indicated that angiogenesis might be an important factor in the mechanism of ovarian endometriosis.