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目的研究血管生成在子宫内膜息肉形成中的作用和宫腔镜子宫内膜息肉切除术(transcervicalresection of polyp,TCRP)对术后子宫内膜再生血管形成的影响。方法子宫内膜息肉患者月经干净后5~7 d行TCRP,取电切下内膜息肉标本25例为子宫内膜息肉组;子宫内膜息肉切除术后1~3个月内,月经干净后3~7 d宫腔镜下取其手术部位内膜20例为TCRP术后组;增殖期子宫内膜25例为对照组。免疫组织化学方法检测各组组织中血管内皮生长因子(VEGF)的表达〔积分光密度(IOD)值〕,显微镜下计数微血管密度(microvessel density,MVD)值。结果子宫内膜息肉组VEGF的表达和MVD值高于对照组和TCRP术后组(P<0.05),而TCRP术后组子宫内膜中VEGF的表达和MVD值与对照组比较差异无统计学意义。结论 TCRP能降低子宫内膜局部的VEGF和微血管生成密度,推测其为TCRP有效治疗子宫内膜息肉的机理之一。
Objective To investigate the role of angiogenesis in the formation of endometrial polyps and the effect of hysteroscopic endoscopic polypectomy (TCRP) on the formation of endometrial neovascularization. Methods TCRP was performed 5 to 7 days after the endometrial polyps were clean, and 25 cases of endometrial polyps were removed from the endometrial polyps for endometrial polyps. Within 1 to 3 months after endometrial polypectomy, 3 to 7 d underwent hysteroscopic surgery in 20 cases of endometrium TCRP group; proliferative endometrium in 25 cases as control group. Immunohistochemistry was used to detect the expression of vascular endothelial growth factor (VEGF) in each group [integrated optical density (IOD) value], and the microvessel density (MVD) value was counted under the microscope. Results The expression of VEGF and MVD in endometrial polyps group were significantly higher than those in control group and TCRP group (P <0.05). However, there was no significant difference in VEGF expression and MVD between TCRP group and control group significance. Conclusions TCRP can decrease the density of VEGF and angiogenesis in the endometrium, suggesting that TCRP is one of the mechanisms of effective treatment of endometrial polyps by TCRP.