Pelvic Adhesions Contain Sex Steroid Receptors and Produce Angiogenesis Growth Factors1

Abstract Objective: To evaluate female pelvic adhesion tissue for the presence of estrogen receptor (ER), progesterone receptor (PR), basic fibroblastic growth factor (basic-FGF), and vascular endothelial growth factor (VEGF). Design: Descriptive study. Setting: Patients at a tertiary medical center. Patients: Female reproductive age patients undergoing gynecologic surgery who were not receiving hormonal therapy. Interventions: Female reproductive tract peritoneal adhesion tissue was excised, frozen, and sent for immunohistologic evaluation. Main Outcome Measure: Presence of ER, PR, basic-FGF, and VEGF in adhesion tissue. Results: Nineteen of 19 specimens were positive for PR; 16 of 19 specimens were positive for ER, which was present in a variety of the different cell types constituting adhesion. Vascular endothelial growth factor and basic-FGF were detected in endothelial cells of blood vessels supplying this tissue as well as in mesothelial cells. Conclusion: Adhesion tissue contains ER, PR, and growth factors that may be important in the genesis of the permanent fibrovascular bands between pelvic organs. This supports the theoretical possibility of hormonal manipulation of these tissues to negatively influence postoperative pelvic adhesion formation.