Study On The Expression Of Ang-2,VEGF And Their Correlation In Endometriosis

Objective:To detect the expression of Ang-2 ( Angiopoiet- in-2),VEGF(vascular endothelial growth factor) in eutopic endometrium,ectopic endometrium in endometriosis and in peritoneal fluid and investigate both relationships in endometriosis and know better its function in the occurrence and development of endometriosis, which is useful to clinical diagnosis and therapy.Methods:1 The study subject:1.1 The study group: 30 patients with ovarian endometriosis who were operated in the gynaecology of the Second hospital of HeBbei medical University were selected from december 2006 to october 2007(congfirmed by the pathology after operated). The study example is endometria (16 patients in the proliferative stage and 14 patients in the secretory stage) Median age of patients with the study group was 36.2 years old(21 to 45years old ). And this group is divivided two small groups: eutopic endometrium groups;ectopic endometrium group.27 patients with ovarian endometriosis belonged to PF group(17 patients in the proliferative stage and 10patients in the secretory stage). Median age of patients with the study group was 25.2years old(21 to 36 years old ).1.2 The control group :30 patients with infertility who were operated with peritoneoscopy during the same hospital and the same periods were chose.The endometrium was confirmed to be normal endometrium through pathology(15 patients in the proliferative stage and 15 patients in the secretory stage). Median age of patients with control group was 30.1 years old(26 to 36 years old ). 15 patients with infertility belonged to PF group(10 patients in the proliferative stage and 5 patients in the secretory stage). Median age of patients with the study group was 30.3 years old(26 to 36 years old ).We distinguished the menstrual cycle on the basis of last mensteual period and the pathology of the endometrium.All of the women in two groups had normal menstrual cycles;no case history of irregularial vaginal bleeding in recent six months;no case history of eating oral contra-ceptive and fixing IUD in recent six months;no case history of treating EMs in recent six months;no case history of hypertension ,heart disease,diabete,renopathy,urgent and chronic pelvic inflammatory disease.no other history.2 Sample collecting: The ectopic endometrium was collected from the study group in their laparoscopic operatings.At the same time,eutopic endometrium was collected,peritoneal fluid was took suction from recto-uterine fossa. The normal endometrium was collected when the control group in their laparoscopic operatings, at the same time, peritoneal fluid was took suction from recto-uterine fossa. The PF was centrifuged 10 min in common temperature 3000r/min, putsupernatant fluid to freezer in -70℃to wait for measure .The endometrium specimen were bathed by the PS again and again fixed by PFA.3 The experiment methods:To determine the expression of Ang-2 and VEGF in the normal endometrium,eutopic endometrium in endometriosis and ectopic endometrium in endometriosis by immuno-histechemical staining ; To determine the expression of Ang-2 in the PF of the control group and the study group by ELISA . To analyze the results by the means of the SPSS13.0.Result:1 Ang-2,VEGF was foud predominately in the epithelioglandular kytoplasm,interstitial cell,blood vessel endothelium cell in the study group and the control group,and they could be foud in the whole menstrual cycle.2 The positive ratio of Ang-2 in the normal endometrium of control group,the eutopic and ectopic endometrium of endometriosis was 16.67%,66.67%,and 40.0%。To compare the expression of Ang-2 among the control group,eutopic endometrium group and ectopic endometrium group,we foud they all had statistically significant:the expression of Ang-2 in the eutopic endometrium group was markely higher than in the control group , and both had significant difference (χ~2=15.429, P<0.05);the expression of Ang-2 in the ectopic endometrium group was markely higher than in the control group , and both had significant difference,(χ~2=4.286 ,P<0.05);the expression of Ang-2 in the eutopic endometrium group was markely higher than in the ectopic endometrium , and had significant difference, (χ~2=4.022, P<0.05); Ang-2 expressed in-persistence in the control group , masculine expressed strength was foud have predominately differences between the proliferative phase and secretion phase(33.33%,0%)and had significance differences(χ~2=6.0, P<0.05); Ang-2 was foud have the resemble masculine expressed strength between the proliferative phase and secretion phase(62.5%,71.4%), and the differences had no significance (χ~2 =0.268, P > 0.05).3 The positive ratio of VEGF in the normal endometrium of control group,the eutopic and ectopic endometrium of endometriosis was 30.0%,93.33%,and 73.30%。To compare the expression of VEGF among the control group,eutopic endometrium group and ectopic endometrium group,we foud they all had statistically significant: the expression of VEGF in the eutopic endometrium group was markely higher than in the control group , and both had significant difference(χ~2=25.452, P<0.05);the expression of VEGF in the ectopic endometrium group was markely higher than in the control group , and both had significant difference(χ~2=11.279 ,P<0.05 );the expression of VEGF in the eutopic endometrium group was markely higher than in the ectopic endometrium group , and both had significant difference (χ~2=4.320, P<0.05); VEGF expressed persistence in the control group , masculine expressed strength was found have predominately differences between the proliferative phase and secretion phase(53.33%,6.7%)and had significance difference(χ~2=7.778, P<0.05); VEGF was found have the resemble masculine expressed strength between the proliferative phase and secretion phase(93.75%,92.86%), and the differences had no significance (χ~2 =0.01, P > 0.05).4 In eutopic endometrium group ,the expression of Ang-2 was related to that of VEGF ( P<0.05 r= 0.725 ) ; in ectopic endometrium group ,the expression of Ang-2 was related to that of VEGF (P<0.05 r= 0.453) ;in normal endometrium group the expression of Ang-2 was related to that of VEGF (P<0.05 r=0.713).5 The level of Ang-2 in the PF in the study group was higher than that in the control group(217±35.39,111.9±25.91)and both had significant difference ( P < 0.05) , The level of Ang-2 in the proliferative phase was higher than that in the secretion phase in the study group(239.4±23.58,181±8.76) and both had significant difference ( P < 0. 05).Conclusion:1 Ang-2 and VEGF effected on promoting vascularization to the study group and the control group , so profited ectopic endometrium to form new vessels and to grow.2 To compare the expression of Ang-2 and VEGF in the contr- ol group,eutopic endometrium group and ectopic endometrium group,we foud they all had statistically significance,these explained higher expression of Ang-2 and VEGF were related to the developing of endometriosis.3 The level of Ang-2 in the PF in the study group was markly higher than that in the control group.4 Statiscal analysis revealed that both Ang-2 and VEGF expression were higher in endometriosis tissues than that in normal endometrium tissues. Ang-2 and VEGF were associated with the occurrence and development of endometriosis.