Abstract
Objective
Endometrial polyp is a common cause of abnormal uterine bleeding, but the etiology
and pathogenesis remain unclear. Vascular endothelial growth factor (VEGF) is angiogenic,
related to thick walled vessels and transforming growth factor-beta1 (TGF-β1) is related
to fibrotic tissue, which are characteristics of endometrial polyps. The primary objective
of this study was to find out if endometrial polyp formation is associated with increased
expression of VEGF or TGF-β1, or both. A secondary objective is to determine if the
changes are related to steroid receptor expression.
Study design
This prospective study compared VEGF and TGF-β1 expression of endometrial polyps and
adjacent endometrial tissue in 70 premenopausal women. The comparison of results was
separately made for endometrium specimens obtained in the proliferative and secretory
phases. The results were correlated with the steroid receptors (estrogen receptor
and progesterone receptor) expression.
Results
The score of VEGF in glandular cells of endometrial polyps was significantly higher
than the score in adjacent endometrium, both in the proliferative phase (P < 0.001) and the secretory phase (P = 0.03); the score of VEGF in stromal cells of endometrial polyps was significantly
higher than the score in adjacent endometrium only in proliferative phase (P = 0.006). The score of TGF-β1 in glandular cells of endometrial polyps was significantly
higher than the score in adjacent endometrium in proliferative phase (P = 0.02); whereas the score of TGF-β1 in stromal cells of endometrial polyps was significantly
higher than the score in adjacent endometrium, both in the proliferative phase (P = 0.006) and the secretory phase (P = 0.008). There was a significant correlation between the expression of steroid receptors
and VEGF and TGF-β1 (Spearman's correlation P < 0.001 and P < 0.05, respectively).
Conclusions
There was increased expression of TGF-β1 and VEGF in polyps compared to adjacent normal
endometrial tissue. It suggested that these cytokines might play a role in endometrial
polyp formation. In addition, there was a significant correlation between steroid
receptor expression and VEGF and TGF-β1 expression.
Keywords
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Article info
Publication history
Published online: June 27, 2011
Accepted:
June 9,
2011
Received in revised form:
March 6,
2011
Received:
September 23,
2010
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.