Morphometric evaluation of stromal vascularization in the endometrium in adenomyosis

A computerized morphometric investigation of stromal vascularization in the endometrium during adenomyosis was performed retrospectively. Using a polyclonal antibody and a peroxidase-antiperoxidase method, formalin-fixed paraffin sections of the tissue were stained for von Willebrand factor, a marker for endothelium. The subjects were divided into two groups: 42 patients with histologically proven adenomyosis and 29 fertile control subjects, 12 in the proliferative phase and 17 in the secretory phase. Objective quantitative colour image analysis was used to assess the staining intensity and hence the degree of vascularization. In the control group, stromal vascularization increased in the secretory phase. In adenomyosis, vascularization increased markedly, up to 11.6 times that of the controls, in terms of the in total surface area of capillaries per mm2 in the endometrium in the proliferative phase. These findings suggest clinical relevance to severe functional disturbances such as hypermenorrhoea or iron deficiency anaemia.