Lymphangiogenesis in deep infiltrating endometriosis
S Keichel, ML Barcena de Arellano… - Human …, 2011 - academic.oup.com
S Keichel, ML Barcena de Arellano, U Reichelt, WFJ Riedlinger, A Schneider, C Köhler…
Human Reproduction, 2011•academic.oup.comBACKGROUND In patients diagnosed with deep infiltrating endometriosis (DIE), foci of
endometriosis are detected in mesorectal lymph nodes (LNs) after segmental bowel
resection and in pelvic sentinel LNs. Lymph vessels (LVs) seem to be the possible routes for
the dissemination of endometriotic cells from DIE-lesions to LN. Therefore, we conducted a
study to investigate the occurrence and density of LV and lymphangiogenic growth factors in
DIE. METHODS Included in this study were 38 premenopausal women who underwent …
endometriosis are detected in mesorectal lymph nodes (LNs) after segmental bowel
resection and in pelvic sentinel LNs. Lymph vessels (LVs) seem to be the possible routes for
the dissemination of endometriotic cells from DIE-lesions to LN. Therefore, we conducted a
study to investigate the occurrence and density of LV and lymphangiogenic growth factors in
DIE. METHODS Included in this study were 38 premenopausal women who underwent …
BACKGROUND
In patients diagnosed with deep infiltrating endometriosis (DIE), foci of endometriosis are detected in mesorectal lymph nodes (LNs) after segmental bowel resection and in pelvic sentinel LNs. Lymph vessels (LVs) seem to be the possible routes for the dissemination of endometriotic cells from DIE-lesions to LN. Therefore, we conducted a study to investigate the occurrence and density of LV and lymphangiogenic growth factors in DIE.
METHODS
Included in this study were 38 premenopausal women who underwent surgery due to symptomatic rectovaginal DIE. In order to identify LV, immunohistochemical analysis with anti-Podoplanin (D2-40), LYVE-1 and Prox-1 was performed. Furthermore, the expression of VEGF-C and VEGF-D in endometriotic tissue was investigated.
RESULTS
LV density (LVD) of DIE lesions was significantly higher compared with healthy corresponding tissue. All LV makers could be detected, and the density of LYVE-1- or Prox-1-positive LV was significantly higher than that of D2-40-positive LV. Endometriotic epithelial cells and stromal cells showed a moderate to strong VEGF-C and VEDF-D expression.
CONCLUSIONS
DIE lesions have lymphangiogenic properties, probably leading to endometriosis-like cells in lymphatic vessels and LNs featuring a loco-regional disease.
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