Lymphangiogenesis in deep infiltrating endometriosis
Abstract
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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The lymphatic metastasis theory of endometriosis is supported by observations of the presence of endometriosis in pelvic lymph nodes and associations between deep-infiltrating endometriosis and lymph node involvement.
“The lymphatic metastasis theory of endometriosis is supported by observations of the presence of endometriosis in pelvic lymph nodes and associations between deepinfiltrating endometriosis and lymph node involvement.[96][97][98]”
From Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France (2013) · cites this paper as [96]
Lymphangiogenesis in deep-infiltrating endometriotic lesions has been reported.
“and lymphangiogenesis in deep-infiltrating endometriotic lesions has been reported.96”
From Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France (2013) · cites this paper as [96]
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- Authors
- Keichel, S., Barcena de Arellano, M. L., Reichelt, U., Riedlinger, W. F. J., Schneider, A., Kohler, C., & Mechsner, S.
- Affiliations
- Stiftung Charité (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Mechsner, S.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-07-25
- Volume
- 26
- Issue
- 10
- Pages
- 2713-2720
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2101766472
- Cited by
- 44
- References
- 44
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 5 · 2015: 3 · 2014: 5 · 2013: 7 · 2012: 3
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- deep infiltrating endometriosis, lymphangiogenesis, lymphatic vessels, lymph node metastasis, VEGF-C, VEGF-D, LYVE-1, Prox1, D2-40, podoplanin, rectovaginal endometriosis, lymphatic vessel density
- MeSH terms
- Prospero-Related Homeobox 1 Protein, Adult, Endometriosis, Female, Gene Expression Regulation, Humans, Immunohistochemistry, Lymph Nodes, Lymphatic Metastasis, Stromal Cells, Premenopause, Homeodomain Proteins, Sentinel Lymph Node Biopsy, Tumor Suppressor Proteins, Vesicular Transport Proteins, Vascular Endothelial Growth Factor C, Lymphangiogenesis, Vascular Endothelial Growth Factor D
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