Elvira Brătilă1, Cornel Petre Brătilă2, Diana-Elena Comandaşu1, Vasilica Bauşic3, Camelia Teodora Vlădescu4, Claudia Mehedinţu5, Costin Berceanu6, Monica Mihaela Cîrstoiu7, George Mitroi8, Ruxandra Stănculescu1
1 Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “St. Pantelimon” Emergency Clinical Hospital, Bucharest, Romania
2 Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of Gynecologic and Pelvic Reconstructive Surgery, Euroclinic Hospital, Bucharest, Romania
3 Department of Histology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “St. Pantelimon” Emergency Clinical Hospital, Bucharest, Romania
4 Department of Pathology, “St. Pantelimon” Emergency Clinical Hospital, Bucharest, Romania
5 Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “Nicolae Malaxa” Clinical Hospital, Bucharest, Romania
6 Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania
7 Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Emergency University Hospital, Bucharest, Romania
8 Department of Urology, University of Medicine and Pharmacy of Craiova, Romania
Corresponding author: Claudia Mehedințu, E-mail: claudiamehedintu@yahoo.com
Abstract:
Endometriosis represents a chronic female genital tract disease characterized by implants outside the endometrial cavity, leading to alteration of pelvic anatomy and having as result chronic pelvic pain and infertility. Aim: From the molecular perspective, the aim of studying endometriosis is identifying a cause and a consequence, that lead to the appearance and perpetual arising of new implants. The description of the immunohistochemical (IHC) profile of ectopic endometrium could represent a new element in the pathogenesis of endometriosis and also a practical method to appreciate the aggressiveness and possibility of recurrence of the disease. The study consisting of histopathological and immunohistochemical (IHC) analysis of the tissues excised included 14 patients, operated from June to December 2014, to which was confirmed the presumptive diagnosis of endometriosis, based on anamnesis, clinical examination and ultrasound appearance. We identified the expression of estrogen and progesterone receptors, whose presence in the ectopic endometrium guides the medical hormone postoperative treatment. We also identified the expression of a cellular proliferation marker – Ki-67, and inhibition marker of cellular apoptosis – Bcl-2, in order to characterize the aggressiveness of endometriosis implantations and a stromal marker CD10. Although there are plenty of medical and surgical therapeutic methods available, the treatment of endometriosis must be individualized for every patient taking into consideration the IHC analysis. Consolidation of surgical treatment by prescription of a medical long-term treatment is indispensable, because endometriosis is a chronic relapsing disease.
Keywords: endometriosis, Bcl-2, Ki-67, estrogen receptor, progesterone receptor.
