PROLIFERATIVE ACTIVITIES OF ECTOPICAL ENDOMETRIAL CELLS IN PATIENTS WITH PRIMARY AND RECURRENT ENDOMETRIOMAS

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Marjorie Caldwell
5 years ago
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1 Federal State Institute «Rostov-on-Don Scientific Research Institute of Obstetrics and Pediatrics», Rostov State Medical University PROLIFERATIVE ACTIVITIES OF ECTOPICAL ENDOMETRIAL CELLS IN PATIENTS WITH PRIMARY AND RECURRENT ENDOMETRIOMAS Svetlana Dubrovina SEUD Congress 2016 Barcelona

2 First described via microscopic observation by Karl von Rokitansky in 1860, symptoms of endometriosis have been noted in medical texts for thousands of years 1, 2. The average gap from the onset of symptoms to the diagnosis of endometriosis is between 3 and 11 years Nezhat C, Nezhat F, Nezhat C. Endometriosis: ancient disease, ancient treatments. Fertil Steril 2012;98(6, Suppl):S1 S Batt R. A History of Endometriosis. London: Springer Science & Business Media; Sherwood S. Endometriosis Fact Sheet. ENDOmetriosis World-wide, March 13, 2014

3 The prevalence of endometriosis is approximately 10-20% among women of reproductive age, and it is 2-5 times higher in women with infertility. 1 The need for subsequent surgery after the initial conservative surgical treatment for endometriosis was 21.6%, 46.7%, and 55.4% at 2, 5, and 7 years after the previous surgery, respectively Kim M-L, Kim J M, Seong SJ et al. Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation. Am J Obstet Gynecol 2014;210:216.e1-6.

4 A higher recurrence rate is reported in younger patients, in those with an advanced disease stage 1,2,3, and in patients who underwent incomplete removal of endometriotic lesions 3, 4. Even after complete resection, endometriosis typically recurs and medical treatment should be used to prevent future disease Kikuchi I, Takeuchi H, Kitade M, Shimanuki H, Kumakiri J, Kinoshita K. Recurrence rate of endometriomas following a laparoscopic cys- tectomy. Acta Obstet Gynecol Scand 2006;85: Liu X, Yuan L, Shen F, Zhu Z, Jiang H, Guo SW. Patterns of and risk factors for recur- rence in women with ovarian endometriomas. Obstet Gynecol 2007;109: Vignali M, Bianchi S, Candiani M, Spadaccini G, Oggioni G, Busacca M. Surgical treatment of deep endometriosis and risk of recurrence. J Minim Invasive Gynecol 2005;12: Carmona F, Martinez-Zamora A, Gonzalez X, Gines A, Bunesch L, Balasch J. Does the learning curve of conservative laparoscopic surgery in women with rectovaginal endometri- osis impair the recurrence rate? Fertil Steril 2009;92: Hufnagel D, Li F, Cosar E, Krikun G, Taylor H. The role of stem cells in the etiology and pathophysiology of endometriosis. Semin Reprod Med 2015;33:

5 However, prognosis and pathogenesis of recurrence of endometrioma are still not fully understood. So far as, we still have not known much about changes occurred in basalis cells of eutopic and ectopic epithelium of endometrial type in patients with endometriosis.

6 The aim of this study was to examine proliferative activities of ectopic endometrial cells in primary and recurrent endometriomas. Samples were obtained from 46 women with primary endometriomas and 15 with recurrence cysts Thickness of slices was 4 mm. The resulting sections were stained in the usual manner with hematoxylineosin and subjected to optical microscopy using immersion objective with a total optical power 10 x 100. Data are presented as the mean ± standart deviation and were analyzed by the Pearson nonparametric correlation to indicate statistical differences between ectopical endometrial cells of primary and recurrence cysts.

7 Studied parameters: The thickness of the gland The core area The thickness of the cytoplasmic membrane The thickness of the nuclear membrane The thickness of the secretory parts of the cell Radius of the nucleus Average brightness The average density of the nucleus

8 The thickness of the gland р=0,004

9 The core area р=0,0001

10 The thickness of the cytoplasmic membrane р=0,003

11 The thickness of the nuclear membrane р=0,035

12 The thickness of the secretory parts of the cell р=0,0001

13 Radius of the nucleus р=0,14

14 Average brightness р=0,0001

15 The average density of the nucleus р=0,0001

16 Visualization of correlations The average density of the nucleus Average brightness The core area The thickness of the cytoplasmic membrane Radius of the nucleus The thickness of the gland The thickness of the secretory parts of the cell The thickness of the nuclear membrane nega&ve posi&ve

17 Conclusion Almost all parameters increasing in the primary cysts may sign more active proliferation in primary cysts in comparison with recurrent cyst. The thickness of all membrane was larger in primary cysts compared with recurrent cysts, maybe because of quantity of specific and nonspecific receptors located in membranes.

18 Liu et al reported that recurrence rates are largely stable for up to 30 months after surgery and decrease thereafter 1. According opinion of Ouchi et al, there is a consistent increase for 5 years, followed by a 0% recurrence rate after 5 years Liu X, Yuan L, Shen F, Zhu Z, Jiang H, Guo SW. Patterns of and risk factors for recurrence in women with ovarian endometriosis. Obstet Gynecol 2007; 109: Ouchi N, Akira S, Mine K, Ichikawa M, Takeshita T. Recurrence of ovarian endometrioma after laparoscopic excision: Risk factors and prevention. J Obstet Gynaecol Res 2014; 40:1:

19 Aim of future investigation To study specific and nonspecific receptors located in nuclear and cytoplasmic membranes. To examine proliferative activities of eutopic endometrial cells with study of morphometric characteristics and compare with ectopic endometrial cells in groups of the women with primary and recurrent endometriomas.

20 Acknowledgements My co-authors: Krasilnikova Lilia, Gimbut Vitaly, Areshuan Knarik, Berlim Julia, Lemeshko Svetlana, Mazhugin Vladimir, Tikidzhieva Victoria

21 Thank you for attention

Comparative morphometric characteristics of eutopic and ectopic endometrial cells in patients with endometriomas

Comparative morphometric characteristics of eutopic and ectopic endometrial cells in patients with endometriomas SEUD Congress 2015 Paris The pathogenesis of early-onset endometriosis has recently been