Enhanced expressions of matrix metalloproteinase (MMP)-2 and -9 and vascular endothelial growth factors (VEGF) and increased microvascular density in the endometrial hyperplasia of women with anovulatory dysfunctional uterine bleeding.

Objective To evaluate the roles of endometrial matrix metalloproteinase (MMP)-2 and -9, vascular endothelial growth factors (VEGF), and microvascular density (MVD) in the occurrence of anovulatory dysfunctional uterine bleeding (DUB). Design A prospective analytical design. Setting The obstetrics and gynecology department of an academic training hospital. Patient(s) Sixty women with anovulatory DUB and 20 control women. Intervention(s) Endometrial biopsies were obtained for the assessment of immunohistochemical staining of MMP-2 and -9, VEGF, and endometrial MVD using an antibody to CD34. Main Outcome Measure(s) The results were determined through the expressions of MMP-2 and -9, VEGF, and CD34. Result(s) The frequencies of MMP-2 and -9 expression in endometrial stroma and of VEGF expression in endometrial glands were all significantly higher in the endometrial hyperplasia of women with anovulatory DUB than they were in the control group. Additionally, the mean score of endometrial MVD was significantly higher in the endometrial hyperplasia of women with anovulatory DUB than it was in the control group. In women with anovulatory DUB, VEGF expression in endometrial glands was statistically correlated with MMP-2 and -9 expressions in endometrial stroma and endometrial MVD. Conclusion(s) These results suggest that enhanced expressions of MMP-2 and -9, VEGF, and increased MVD in endometrial hyperplasia may play important roles in the pathogenesis of women with anovulatory DUB.