The Significance And Expression Of Ang-2, VEGF And ENS In Endometriosis

Endometriosis(EMs) is a common gynecologic disease, which can mainly cause the clinical symptoms such as infertility, dysmenorrhoea and the pain of pelvic cavity, impact on healthy and life quality of reproductive women. EMs is a benign condition though its pattern of growth is similar to malignant disease. It is difficult to be treated with medicine because of obvious side effects and high recuverrence rate . Basic and clinical study on endometriosis aroused many experts home and abroard attention. Although the pathogenesis of endometriosis remains unknown,the successful implantation and growth of endometrial tissue within the peritoneal cavity is dependent upon its ability to establish and maintain an adequate blood supply, newvascularization (angiogenesis) is therefore a key part in the progression of endometriosis.Angiogenesis is a complex process which reguires the co-operation of a variety of molecules and cells and depends upon the balance between positive and negative regulators.Angiopoietin-2(Ang-2) is an important which plays an important role in physiologic and pathologic angiogenesis. Studies about Ang-2 concentrate on tumor and there are no reports in endometriosis.Vascular endothelial growth factor (VEGF) is a vital angiogenic stimulator of the known angiogenic factor.Many studies show that the fluid from the peritoneal cavity of patients with endometriosis contains significantly greater amounts activity of VEGF than that from control group It indicates that evevating angiogenic activity of VEGF increases endometrium angiogenesis and plays an important role in endometriosis.. Endostatin (ENS) is an antiangiogenic factor which can inhibit the newvascularization. Studies show ENScan inhibit the newvascularization of VEGF.There is obvious angiogonesis in endometriosis,but the mechenism is unknown. To invesitigate the expression of some angiogonesis regulating molecules is conductive to identify the pathogenesis of endometriosis. These deserve to be further studied so as to provide a new treatment ategy for endometriosis.In this study, we investigated the expression of Ang-2,VEGF and ENS in ectopic and eutopic endometrium with EMs by means of immunohistochemistry. The purpose is to explore the effect and meaning of these angiogenic inhibitor to treat EMs.Materials and Methods:Patients with endometriosis (n=30) accepted operation and the specimen were collected at gynecological departmert of the Third Affiliated Hospital of Zhengzhou University. The age of patients ranged from 24 to 48. In addition,30 control endometriums were collected in the same hospital, the age ranged from 22 to 45 .All patients had no physical and surgical disease and had not accepted the hormone therapy six months before operation. All diagnoses of specimens were confirmed by pathlogy.We examined the expression of Ang-2 VEGF and ENS in eutopic and ectopic endometrium by immunohistochemistry. The study used the Biosens Digital System to exam the average gray value of production of Ang-2 VEGF and ENS positive reactivity. Statistical analysis was performed with SPSS 11.0 soft. Statistically significant level was considered as "alpha equals 0.05".Results:1 The expression of Ang-2 in eutopic and ectopic endometrium group was significantly higher than that in normal control endometrium group (P<0.05).There was no significant difference between eutopic and ectopic endometrium group (P>0.05). The expression of Ang-2 was regular in normal endometrium and eutopic endometrium of EMs, which was higher in the secretive phase than that in the proliferative phase (P<0.05). The eutopic endometrium of women with EMs both in the proliferative phase and secretive phase expressed higher level of Ang-2 than that of the control group (P<0.05).2 The expression of VEGF in eutopic and ectopic endometrium group was significantly higher than that in normal control endometrium group (P<0.05).There was no significant difference between eutopic and ectopic endometrium group (P>0.05). The expression of VEGF was regular in normal endometrium and eutpic endometrium of EMs which was higher in the secretive phase than that in the proliferative phase (P<0.05). The eutopic endometrium of women with EMs both in the proliferative phase and secretive phase expressed higher level of VEGF than that of the control group (P<0.05).3 The expression of ENS in ectopic endometrium group was higher than that in normal control and eutopic endometrium group (P<0.05). The expression of ENS in eutopic endometrium group was higher than that in normal control group(P<0.05). The expression of ENS was regular in normal endometrium which was higher in the secretive phase than that in the proliferative phase (P<0.05). There was not this phenomenon in eutopic endometrium group(P>0.05). There was significant difference between two groups in proliferative phase (P<0.05) and no difference in secretive phase(P>0.05).4 In eutopic endometrium group, according to the relative analysis, the correlation coefficient of Ang-2 and VEGF was r=0.784, P<0.05; the correlation coefficient of VEGF and ENS was r=-0.2, P>0.05.Conclusions:1 The expression of Ang-2 in eutopic and ectopic endometrium group was higher which suggested that Ang-2 had an important role in endometriosis development and angiogenesis.2 The expression of VEGF in EMs was higher than that in control gronp, it suggested VEGF played an important role in the development of endometriosis.3 The expression of ENS in eutopic and ectopic endometrium group was higher which suggested that it had an important role in endometriosis development.4 Therefore, we supposed that applying angiogenic inhibitor in treating EMs may be an effective means which can improve effect of diverse therapies.