Article
Growth and de novo generation of cavernous malformations
Wachstum und Neubildung von zerebralen kavernösen Malformationen
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Published: | May 8, 2006 |
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Objective: Cerebral cavernous malformations (CCM) are considered to be congenital and static malformations. On the other hand, the potential of growth and de novo generation of CCM have been reported. It was therefore of interest to study the proliferative and neoangiogenetic capacity of these lesions.
Methods: The surgical specimens of 56 CCM (23 deep, 33 superficial) from adult patients and 19 controls were studied. The proliferative activity of the endothelium and the neoangiogenetic capacity of these lesions were investigated by immunohistochemistry for the PCNA, MIB-1, Flk-1, VEGF, HIF-1α, and endoglin antibodies, respectively.
Results: Positive immunostaining of endothelial cells was observed in 86% of patients for PCNA and in 38% of the cases for MIB-1. The expression of Flk-1 was determined in the endothelium of 71% of the cases, for VEGF in 41%, for HIF-1α in 48%, and for endoglin in 64% of the individuals, respectively. The correlation of immunohistochemical and clinical data showed that VEGF was expressed significantly less in deep-seatedCCM than in superficial CCM. Neither the expression of the proliferative markers, nor the expression of the angiogenetic antibodies correlated with the age at surgery, the gender, or the episodes of recent prior hemorrhages in our patients.
Conclusions: CCM in adult patients are active lesions exhibiting endothelial proliferation and neoangiogenesis. According to our data, neoangiogenesis is more prominent in superficial CCM than in deep seated CCM, and is rarely associated with recent prior hemorrhages.