Expression And Clinical Significance Of VEGF,ENS And MVD In Adenomyosis

Objective1.To study the expression of vascular endothelial growth factor (VEGF),Endostatin (ENS) and Microvessel density (MVD)in eutopic and ectopic endometrium of adenomyosis and normal endometrium;To evaluate whether VEGF,ENS and MVD are significantly correlated with each other or not;To detect the role of VEGF,ENS and MVD in adenomyosis mechanism.2.To evaluate whether the expression of VEGF,ENS and MVD in adenomyosis patients who had menorrhagia or not or had dysmenorrhea or not are different or not, the objective is to give clinical reference for a new idea that using angiogenesis inhibitor in treatment of adenomyosis.Materials and Methods1. Samples51 patients who had undergone hysterectomy because of adenomyosis in this study.51 ectopic and eutopic endometrium tissue specimens are obtained from these patients,and are respectively acted as study group A and group B. 40 normal endometrium tissue samples obtained from women without estrogen-dependent disorders and immune diseases ,were acted as control group. All of above samples are diagnosed by pathology. No hormone was used within 3 months in all women.2.MethodsImmunohistochemical technique was used to measure the expression of VEGF,ENS and CD34 which was used to represent MVD in endometrial cells(histochemistry score).3. Satistical analysisThe results were analyzed with SPSS13.0 statistical software.Means between groups were compared by using group LSD-t test or t'-test and homogeneity of variance test, results were recorded as x±S.Correlation between two variables was examined by Partial relevance analysis.Significance was set at P<0.05.Results1.Expressions of VEGF,ENS,MVD and VEGF/ENS in group A were significantly higher than that in group B and control group(P<0. 05).Expressions of VEGF,MVD and VEGF/ENS in group B were significantly higher than that in control group(P<0.05),but the expression of ENS in group B were not significantly higher than that in control group(P>0.05).2. In control group,expressions of VEGF,ENS,MVD and VEGF/ENS were periodical and significantly higher in secretory endometrium than proliferative endometrium(P<0.05). In group B,expressions of VEGF,MVD and VEGF/ENS were periodical and significantly higher in secretory endometrium than proliferative endometrium(P<0.05).However,there was no difference between proliferative phase and secretory phase in group A.3.There was positive correlation between the expression of VEGF,VEGF/ENS protein and MVD at normal endometrium,ectopic and eutopic endometium of adenomyosis(r=0.36,0.43;P<0.05),but in those tissues,there was negative correlation between the expression of ENS protein and MVD(r=-0.22,P<0.05). 4. Menorrhagia of adenomyosis maybe had correlation with the expression of VEGF,MVD and VEGF/ENS in eutopic endometrium of adenomyosis(P < 0.05). Dysmenorrhea of adenomyosis maybe had no correlation with the expression of these protein in eutopic endometrium of adenomyosis(P>0.05).Conclusions1.The high expressions of VEGF,MVD and VEGF/ENS in ectopic and eutopic endometrium of adenomyosis,It suggests that local angiogenesis is related to pathogenesis of adenomyosis; the ratios of VEGF and ENS is disequilibrium,it may be to hint the increasing of angiogenesis in the endometrium is related to the relative overexpression of VEGF,the local tissues have enough blood to invade into the muscular layer of uterus and continue to grow.2.The higher expression of VEGF,MVD and VEGF/ENS in eutopic endometrium of adenomyosis patients that have menorrhagia.We may be to guess the menorrhagia is related to capillaries and the exposed vessel in uterus of adenomyosis patients may be more.The happen of Dysmenorrhea in adenomyosis patients maybe have no relation with these factors.