| ObjectiveEndometriosis (EMs) is a gynecological medical condition in which active cells from the lining of the uterus (endometrium) appear and flourish outside theuterine cavity. It is typically seen during the reproductive years with a incidence of10-15%. Although endometriosis is one of the most frequent benign gynecological diseases, it has strong proliferative capability with malignant tumor characteristics like hyperplasia, invasion, recrudescence etc, causing pelvic pain, dyspareunia and infertility, which has been vividly called "benign cancer" and women’s pelvic "sandstorm". Various theories have been promulgated to explain the pathogenesis of endometriosis, but the exact cause remains unknown. In recent years, many studies have shown that endometriosis is one of the family ofangiogenic diseases and excessive endometrial angiogenesis is proposed as an important mechanism in the pathogenesis of endometriosis. Studying on the regulation of neovascularization has become a hotspot in research of pathogenesis and treatment of endometriosis.Vascular endothelial growth factor (VEGF) is the most powerful and important angiogenic molecule, which can effect on the endothelial cells of vascular directly and specially, resulting in neovascularization. It’s very important in metastasis and implanting of ectopic endometrial cells. At present, the research of VEGF level in patients with endometriosis is focused on peritoneal cavity fluid, normal and ectopic endometrium, with serum levels reported rarely.Insulin-like growth factor-Ⅰ (IGF-Ⅰ) is a growth factor exerting a variety of biological functions. It can promote cell proliferation and differentiation, anti-apoptosis,(lymph)angiogenesis. It had been reported that intimal lesion of the effects of correlation between size and IGF-Ⅰ mRNA expression level of significance, shows partial IGF-Ⅰ gene expression is related to Ectopic implantation of endometrial.Studies about IGF-Ⅰ in serum of endometriosis patients were very little with different outcomes.It has not been reported about the combined detection of VEGF and IGF-Ⅰ of the serum levels in endometriosis patients at home and abroad. In this study, the serum levels of VEGF and IGF-Ⅰ in patients with endometriosis are detected and the correlation between them is analyzed, aiming to investigate the role of VEGF and IGF-Ⅰ in the progression of endometriosis and obtain guidances in clinical diagnosis in EMs.Methods1. Experimental groups1.1Experimental group:40patients were chosen in the Second Affiliated Hospital of Zhengzhou University from December2010to June2011.All of them, aged from20to46, were confirmed for endometriosis after surgery and pathology, with average age30.7. According to the revised Ameriean fertility Society1985(r-AFS) staging standard, Ⅰ-Ⅱ19cases, and Ⅲ-Ⅳ21cases.1.2Control group:Selected40cases in the same period in patients given surgical treatment because of ovarian cysits,with postoperative pathological examination confirmed with ovarian mature teratoma and serous cystadenoma, aged from19to55, with average age35.4.1.3Inclusion criteria:All the experimenters were not administered with hormone drugs during half a year, excluding of endoerine disease, uterine fibroids, adenomyosis, mammary hyperplasia and other hormone-dependent disease.2. Experimental methods All patients’fasting venous blood was taken before the operations.VEGF and IGF-I concertrations were detected by ELISA (enzyme linked immuno sorbent assay, ELISA). Database was established by Excel2000and analyzed by SPSS17.0. P<0.05was considered to be statistically significant.Results1. The serum levels of VEGF and IGF-I in patients with endometriosis were higher than those in the control group (P<0.05).2. The serum levels of VEGF and IGF-I in stage Ⅲand Ⅳ were higher than those of stage I and II (P<0.05).3. The VEGF serum levels were correlated positively with that of IGF-I in patients with endometriosis (r=0.508, P<0.05).4. Simultaneously testing the VEGF and IGF-I serum levels has high specificity (95%) in diagnosis of endometriosis.Conclusions1. The high VEGF and IGF-I serum levels in endometriosis suggest that they may be involved in the progression of endometriosis, and they are related to its severity of the disease.2. VEGF and IGF-I may take synergetic effects in the progression of endometriosis.3. It may be valuable to detect the serum levels of VEGF and IGF-I in the diagnosis of endometriosis. |
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