Expression of cyclooxygenase-2 and vascular endothelial growth factor in ovarian endometriotic cysts and their relationship with angiogenesis.

OBJECTIVE

To investigate the expression of cyclooxygenase-2 (Cox-2) and vascular endothelial growth factor (VEGF) in ovarian endometriotic cysts and assess their relation with angiogenesis.

DESIGN

Experimental clinical study.

SETTING

University hospital.

PATIENT(S): Fifty patients with ovarian endometriotic cysts.

INTERVENTION(S): Surgical excision of 50 ovarian endometriotic cysts.

MAIN OUTCOME MEASURE(S): Microvessel density and the expression of Cox-2 and VEGF were analyzed immunohistochemically.

RESULT(S): Cyclooxygenase-2 immunoreactivity was mainly cytoplasmic in glandular epithelial cells in all of the ovarian endometriotic cysts, with low expression in 12 cases (24%), moderate expression in 21 (42%), and high expression in 17 (34%). Vascular endothelial growth factor immunoreactivity was mainly cytoplasmic in stromal cells in 46 (92%) of the ovarian endometriotic cysts, with low expression in 12 cases (24%), moderate expression in 18 (36%), and high expression in 16 (32%). No immunoreactivity was present in 4 cases (8%). Both Cox-2 (r = 0.728) and VEGF (r = 0.670) were closely, statistically significantly related with microvessel density in ovarian endometriotic cysts. Cyclooxygenase-2 and VEGF also were highly statistically significantly correlated (r = 0.777) with each other.

CONCLUSION(S): We observed Cox-2 expression mostly in glandular epithelial cells of ovarian endometriotic cysts, whereas VEGF expression was observed mainly in stromal cells. Cyclooxygenase-2 and VEGF were closely correlated with each other, and both of them appear to play a role in the angiogenesis of ovarian endometriosis.