子宫内膜异位症幼稚微血管分布特征

Clinical-Pathologic Features of Microvessel in Endometriosis

目的:探讨卵巢子宫内膜异位症(OEMs)和子宫腺肌病(AM)合并存在的子宫内膜异位症(EMs)患者在位子宫内膜、OEMs异位内膜、AM异位内膜血管形成特征。方法:以OEMs和AM合并存在的38例EMs患者和31例正常对照组子宫内膜为研究对象,用免疫组化SP法检测血管内皮生长因子(VEGF)表达,免疫组化双染法定位血管内皮细胞及周细胞、计数微血管密度(MVD)和微血管周细胞覆盖指数(MPI)。结果:(1)OEMs异位内膜的VEGF在全周期高表达,AM及在位内膜的VEGF在分泌期高表达。(2)AM的MVD高于正常内膜、同体在位内膜及OEMs异位内膜(均P<0.01);OEMs的MVD稍高于在位内膜(P<0.05)。(3)EMs患者异位内膜表层及基底层的MPI低于正常内膜,以AM最为突出(均P<0.01)。(4)VEGF与MVD、MPI无明显相关性,而MVD与MPI呈负相关。结论:(1)血管形成机制在AM发病中占极重要地位。(2)在位内膜异常是EMs病变形成的基础。(3)AM幼稚微血管生成更活跃。

Objective： To investigate the angiogenetic characteristics by immunohistochemistry method in patients with ovary endometriosis （OEMs） and adenomyosis （AM） combined with endometriosis（EMs）. Methods： Thirty-eight patients with OEMs and AM combined with endometriosis EMs and 31 healthy control were included in this study. The expression of vas-cular endothelial growth factor （VEGF） was detected by immunohistochemistry. The vascular endothelial cell （VEC） and perithelial cell,microvessel density （MVD） and microvessel pericyte coverage index （MPI）were detected by dual-immuno-histochemistry. Results： The level of VEGF was higher during all period of menstruation in the ectopic endometrium of OEMs,while the expression of VEGF was only increased in secretary phase in adenomyosis and eutopic endometrium. The MVD of AM was significantly higher than endometrium and OEMs（P 〈 0.01）. The microvessel pericytes coverage index （MPI） was significantly decreased in both OEMs and AM （ P 〈 0.01）. There were no significant correlation amony VEGF,MVD and MPI. There was a negatively correlation between MVD and MPI. Conclusion：Angiogenesis exerts a very important role in endometriotic pathogenesis. Abnormality of eutopic endmetrium may be a decisive factor in ectopic lesion formation. Angiogenesis is more active in AMs.