血管内皮生长因子及其激酶插入区受体在卵巢子宫内膜异位症中的表达及意义

翟敬芳; 丛林; 欧玉荣

血管内皮生长因子及其激酶插入区受体在卵巢子宫内膜异位症中的表达及意义

The significance of the expression of vascular endothelial growth factors and its receptor KDR in ovarian endometriosis

摘要

摘要: 目的:探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)及其激酶插入区受体(kinase insert domain receptor,KDR)在卵巢子宫内膜异位症(ovarian endometriosis,OEM)在位内膜和卵巢异位内膜及其周围卵巢组织中的表达及在OEM发病机制中的作用。方法:应用免疫组织化学S-P法测定VEGF和KDR在51例Ⅱ~Ⅲ期OEM患者的44份卵巢子宫内膜异位囊肿及其邻近卵巢组织、20份子宫内膜组织及18份非子宫内膜异位症(非内异症)患者增生期子宫内膜组织中的表达,并对表达结果进行分析。结果:VEGF和KDR主要分布于子宫内膜及异位内膜的腺上皮细胞质中。VEGF和KDR在卵巢异位上皮的阳性率分别为63.6%、54.6%,而在异位上皮邻近卵巢组织的阳性率分别为6.8%、15.9%,VEGF和KDR在异位内膜的阳性率均高于卵巢异位内膜邻近卵巢组织(P=0.000 1和P=0.008 4),且两者在异位内膜的表达呈正相关关系(P=0.000)。VEGF和KDR在OEM子宫内膜中的阳性率分别为80.0%、75.0%,而在非内异症子宫内膜中的阳性率分别为16.7%、27.8%,VEGF和KDR在在位内膜中的阳性率同对照组子宫内膜上阳性率的差异均有统计学意义(P<0.01)。两者在OEM卵巢异位内膜和在位内膜上的阳性率相似,差异均无统计学意义(P>0.05)。结论:VEGF与KDR在卵巢异位内膜中的阳性率明显高于邻近卵巢组织,提示VEGF与受体KDR协同表达可能与OEM血管生成有密切关系。VEGF、KDR在OEM在位内膜的阳性率高于非内异症组子宫内膜,且两者在OEM卵巢异位内膜和在位内膜上的阳性率相似,支持在位内膜决定论学说。

Abstract: Objective: To investigate the expressions of vascular endothelial growth factor (VEGF) and its kinase insert domain receptor (KDR) in eutopic endometrium and ovarian ectopic endometrium and its surrounding ovarian tissue patients with ovarian endometriosis (OEM),and to explore their roles in the mechanism of development of OEM.Methods: Using immunohistochemical S-P technique,the expressions of VEGF and KDR were examined and analyzed in the tissue of ovarian ectopic endometrium (44 specimens),ovarian tissue surrounding ectopic endometrium (44 specimens) and eutopic endometrium (20 specimens) from 51 women patients with OEM (stage Ⅱ-Ⅲ) compared with their expressions in the control proliferative eutopic endometrium without endometriosis (18 specimens).Results: VEGF and KDR expressions were mainly located in the cytoplasm of gland epidermis in eutopic and ectopic endometrium.The positive rates of VEGF and KDR proteins in ovarian ectopic endometrium were 63.6% and 54.6%,respectively,while the positive rates in ovarian tissue surrounding ectopic endometrium were only 6.8%,15.9%,respectively.The positive rates of VEGF and KDR proteins in ovarian ectopic endometrium were both significantly higher than those in ovarian tissue surrounding ectopic endometrium (P=0.000 1 and P=0.008 4).And their synchronization expressions in ectopic endometrium were a positive correlation (P=0.000).The positive rates of VEGF and KDR proteins in eutopic endometrium with endometriosis were 80.0% and 75.0%,respectively,while the positive rates in eutopic endometrium without endometriosis were only 16.7% and 27.8%,respectively.The difference of VEGF and KDR in eutopic endometrium with endometriosis compared with that without endometriosis was significant (P<0.01).The expressions of them in ectopic and eutopic endometrium with endometriosis was similar and not statistical significant (P>0.05).Conclusions: The expressions of VEGF and KDR in ectopic endometrium tissue were both significantly higher than those in ovarian surrounding tissue.Therefore their synchronization expressions might be relative to angiogenesis in ovarianendometriosis.The expressions of VEGF and KDR in eutopic endometrium with endometriosis were significantly higher than those without endometriosis,and the expressions of them in ectopic and eutopic endometrium with endometriosis were similar,which supported the theory "determinant of uterine eutopic endometrium".

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