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The association between endometriosis and chronic endometritis.

Takebayashi A, Kimura F, Kishi Y, Ishida M, Takahashi A, Yamanaka A, Takahashi K, Suginami H, Murakami T - PLoS ONE (2014)

Bottom Line: Furthermore, the 71 patients were also divided into two groups, 28 with chronic endometritis (chronic endometritis group) and 43 without chronic endometritis (non-chronic endometritis group).Logistic regression analysis was performed with variables including age, body mass index (BMI), gravidity and parity, and diagnoses of leiomyoma, adenomyosis, and endometriosis on pathology to examine the independent effect of each variable on chronic endometritis.This result suggests a strong association between endometriosis and chronic endometritis.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, Japan.

ABSTRACT

Objective: To evaluate the association between endometriosis and chronic endometritis.

Methods: Endometrial specimens were obtained from 71 patients, 34 with endometriosis (endometriosis group) and 37 without endometriosis (non-endometriosis group), who underwent hysterectomy, and the specimens were immunostained for the plasmacyte marker CD138. The rate of chronic endometritis was compared between the endometriosis group and the non-endometriosis group. Furthermore, the 71 patients were also divided into two groups, 28 with chronic endometritis (chronic endometritis group) and 43 without chronic endometritis (non-chronic endometritis group). Logistic regression analysis was performed with variables including age, body mass index (BMI), gravidity and parity, and diagnoses of leiomyoma, adenomyosis, and endometriosis on pathology to examine the independent effect of each variable on chronic endometritis. Patients suffering from cervical invasive carcinoma, endometrial carcinoma, and endometrial polyps or treated with gonadotropin-releasing hormone agonists, progestins, or oral contraceptives before surgery were excluded.

Results: Chronic endometritis was identified in 52.94% of the endometriosis group and 27.02% of the non-endometriosis group (p<0.05). Logistic regression analysis revealed that endometriosis was associated with chronic endometritis.

Conclusions: This result suggests a strong association between endometriosis and chronic endometritis.

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Related in: MedlinePlus

The number of accumulated immunoreactive cells in one HPF.All cases with over 11 plasma cells in one HPF belong to the endometriosis group.
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pone-0088354-g002: The number of accumulated immunoreactive cells in one HPF.All cases with over 11 plasma cells in one HPF belong to the endometriosis group.

Mentions: Kitaya et al. immunostained 234 specimens obtained by hysterectomy due to benign gynecological disease and reported that chronic endometritis was identified in 11.1% of the endometrial specimens [30]. Compared to their result, the rate of chronic endometritis was higher in the present study. They reported that the number of immunoreactive cells in 10 non-overlapping stromal areas varied from 12 to 56 in 26 chronic endometritis cases. They excluded the patients with less than 12 immunoreactive cells. The difference in the diagnostic criteria may explain the dissimilar results. In the present study, the stromal area where the greatest number of plasma cells was present in each patient was evaluated, and the greatest number in one HPF for each patient was recorded. When comparing the number of patients with more than 6 plasma cells in one HPF, the overall percentage was significantly higher in the endometriosis group than in the non-endometriosis group (29.41% vs. 5.4%, p = 0.0101). Moreover, when the numbers of patients with over 11 plasma cells in one HPF were compared, the percentage was significantly higher in the endometriosis group than in the non-endometriosis group (17.65% vs. 0%, p = 0.0094). All patients with more than 11 plasma cells in one HPF belonged to the endometriosis group (Figure 2). Based on these results, two things may be suggested. First, even if the criterion of chronic endometritis is different, the prevalence of chronic endometritis is higher in the endometriosis group. Second, the inflammation of chronic endometritis is severe in endometriosis patients. Wood et al. claimed that increased mucosal plasma cell counts in the duodenal mucosa of patients with celiac disease mirrored increased local production of immunoglobulins [31] that increase in response to infection, chronic inflammation, and autoimmune disease [32]. Thus, when thinking about the endometrium, it is possible to say that accumulation of plasmacytes is related to the severity of chronic inflammation in the endometrium, and chronic endometritis in endometriosis may be more active, but the reason why they accumulate in chronic endometritis still needs to be identified.


The association between endometriosis and chronic endometritis.

Takebayashi A, Kimura F, Kishi Y, Ishida M, Takahashi A, Yamanaka A, Takahashi K, Suginami H, Murakami T - PLoS ONE (2014)

The number of accumulated immunoreactive cells in one HPF.All cases with over 11 plasma cells in one HPF belong to the endometriosis group.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928198&req=5

pone-0088354-g002: The number of accumulated immunoreactive cells in one HPF.All cases with over 11 plasma cells in one HPF belong to the endometriosis group.
Mentions: Kitaya et al. immunostained 234 specimens obtained by hysterectomy due to benign gynecological disease and reported that chronic endometritis was identified in 11.1% of the endometrial specimens [30]. Compared to their result, the rate of chronic endometritis was higher in the present study. They reported that the number of immunoreactive cells in 10 non-overlapping stromal areas varied from 12 to 56 in 26 chronic endometritis cases. They excluded the patients with less than 12 immunoreactive cells. The difference in the diagnostic criteria may explain the dissimilar results. In the present study, the stromal area where the greatest number of plasma cells was present in each patient was evaluated, and the greatest number in one HPF for each patient was recorded. When comparing the number of patients with more than 6 plasma cells in one HPF, the overall percentage was significantly higher in the endometriosis group than in the non-endometriosis group (29.41% vs. 5.4%, p = 0.0101). Moreover, when the numbers of patients with over 11 plasma cells in one HPF were compared, the percentage was significantly higher in the endometriosis group than in the non-endometriosis group (17.65% vs. 0%, p = 0.0094). All patients with more than 11 plasma cells in one HPF belonged to the endometriosis group (Figure 2). Based on these results, two things may be suggested. First, even if the criterion of chronic endometritis is different, the prevalence of chronic endometritis is higher in the endometriosis group. Second, the inflammation of chronic endometritis is severe in endometriosis patients. Wood et al. claimed that increased mucosal plasma cell counts in the duodenal mucosa of patients with celiac disease mirrored increased local production of immunoglobulins [31] that increase in response to infection, chronic inflammation, and autoimmune disease [32]. Thus, when thinking about the endometrium, it is possible to say that accumulation of plasmacytes is related to the severity of chronic inflammation in the endometrium, and chronic endometritis in endometriosis may be more active, but the reason why they accumulate in chronic endometritis still needs to be identified.

Bottom Line: Furthermore, the 71 patients were also divided into two groups, 28 with chronic endometritis (chronic endometritis group) and 43 without chronic endometritis (non-chronic endometritis group).Logistic regression analysis was performed with variables including age, body mass index (BMI), gravidity and parity, and diagnoses of leiomyoma, adenomyosis, and endometriosis on pathology to examine the independent effect of each variable on chronic endometritis.This result suggests a strong association between endometriosis and chronic endometritis.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, Japan.

ABSTRACT

Objective: To evaluate the association between endometriosis and chronic endometritis.

Methods: Endometrial specimens were obtained from 71 patients, 34 with endometriosis (endometriosis group) and 37 without endometriosis (non-endometriosis group), who underwent hysterectomy, and the specimens were immunostained for the plasmacyte marker CD138. The rate of chronic endometritis was compared between the endometriosis group and the non-endometriosis group. Furthermore, the 71 patients were also divided into two groups, 28 with chronic endometritis (chronic endometritis group) and 43 without chronic endometritis (non-chronic endometritis group). Logistic regression analysis was performed with variables including age, body mass index (BMI), gravidity and parity, and diagnoses of leiomyoma, adenomyosis, and endometriosis on pathology to examine the independent effect of each variable on chronic endometritis. Patients suffering from cervical invasive carcinoma, endometrial carcinoma, and endometrial polyps or treated with gonadotropin-releasing hormone agonists, progestins, or oral contraceptives before surgery were excluded.

Results: Chronic endometritis was identified in 52.94% of the endometriosis group and 27.02% of the non-endometriosis group (p<0.05). Logistic regression analysis revealed that endometriosis was associated with chronic endometritis.

Conclusions: This result suggests a strong association between endometriosis and chronic endometritis.

Show MeSH
Related in: MedlinePlus