Haemorrhoids are related to changes of cell function in mucosa and submucosa.

Epidemiology and risk factors of haemorrhoidal disease are not well defined. This study tried to evaluate if the appearance of haemorrhoids is related to a disturbed remodelling of the soft tissue of rectal mucosa and submucosa. Therefore, immunohistochemical expression profiles of five parameters as potential mediators in neoangiogenesis ( EGFR), in inflammatory cell activity ( COX-2), and in cell migration, differentiation, and wound healing ( notch-3, c-myc, and ß-Catenin) were analysed (Saed et al., Fertil Steril 83(Suppl 1):1216–1219, ; Saed et al., Fertil Steril 79:1404–1408, ; Stojadinovic et al., Am J Pathol 167:59–69, ). Haemorrhoidal tissue specimens were collected from 44 patients. Healthy rectal mucosa was obtained from 16 non-fixed fresh cadavers and served as control. Histological and immunohistochemical markers like EGFR, COX-2, notch-3, c-myc, and ß-Catenin were analysed semi-quantitatively, separately for mucosal and submucosal layer. Significantly increased expressions were found for EGFR, COX-2, and notch-3 in the mucosal and submucosal layer of haemorrhoidal tissue in comparison to normal rectal tissue. This finding confirms that haemorrhoidal disease may be regarded as a manifestation of a soft tissue disease. [ABSTRACT FROM AUTHOR]