Istrate-Ofiţeru Anca Maria, Pirici Daniel, Niculescu Mihaela, Berceanu Costin, Berceanu Sabina, Voicu Nicoleta Loredana, Piringă Georgeta Diana, Roşu Gabriela Camelia, Iovan Larisa, Căpitănescu Răzvan Grigoraş, Diţescu Damian, Sava Anca, Mogoantă Laurenţiu, Neacşu Adrian
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital of Craiova, Romania;
Rom J Morphol Embryol. 2018;59(4):1133-1153.
Endometriosis is a benign pathology, commonly found in women at reproductive age. It is represented by the ectopic presence of the endometrial glandular epithelium in several tissues and organs. This ectopically located tissue can display premalignant or even malignant changes under the influence of certain factors that affect cell structure, function and proliferation. Our study includes a total of 28 patients, with endometriosis of different localizations: ovarian or pelvic endometriosis, adenomyosis or endometriosis of the abdominal wall. We performed a clinical and statistical analysis upon the collected clinical and laboratory data, together with the results obtained by using classical histological and immunohistochemical (IHC) profiling. The classical staining revealed the existence of the ectopic glandular epithelium, while the IHC reactions obtained with the anti-cytokeratin (CK) 7∕anti-CK20, anti-estrogen receptor alpha (ERα)∕anti-progesterone receptor (PR) antibodies, ascertained that these tissues were of endometrial origin. The environmental, hormonal or inflammatory factors influence these areas, so that the ER∕PR scores may be modified, the cellular proliferation might be increased (Ki67+ marker), the anti-apoptotic B-cell lymphoma 2 (BCL2) protein expression and phosphatase and tensin homolog (PTEN) may also be modified. Moreover, tumor protein 53 (p53) was positive in cases with atypia, density of inflammatory cells clearly increased compared to the adjacent normal endometrium, respectively with cluster of differentiation (CD) 3+, CD20+, CD68+, CD79a+, and tryptase+ cells, all of which may influence the cellular structure, histological architecture of the surrounding microenvironment and cause premalignant or even malignant changes in endometriosis outbreaks.
子宫内膜异位症是一种良性病变，常见于育龄女性。它表现为子宫内膜腺上皮在多个组织和器官中的异位存在。这种异位组织在影响细胞结构、功能和增殖的某些因素作用下，可能会出现癌前甚至恶性变化。我们的研究共纳入28例患者，患有不同部位的子宫内膜异位症：卵巢或盆腔子宫内膜异位症、子宫腺肌病或腹壁子宫内膜异位症。我们对收集到的临床和实验室数据进行了临床和统计分析，并结合使用经典组织学和免疫组织化学（IHC）分析所获得的结果。经典染色显示存在异位腺上皮，而用抗细胞角蛋白（CK）7∕抗CK20、抗雌激素受体α（ERα）∕抗孕激素受体（PR）抗体进行的IHC反应，确定这些组织起源于子宫内膜。环境、激素或炎症因素会影响这些区域，从而可能改变ER∕PR评分、增加细胞增殖（Ki67+标记），抗凋亡的B细胞淋巴瘤2（BCL2）蛋白表达以及磷酸酶和张力蛋白同源物（PTEN）也可能发生改变。此外，非典型病例中肿瘤蛋白53（p53）呈阳性，与相邻正常子宫内膜相比，炎症细胞密度明显增加，分别有分化簇（CD）3+、CD20+、CD68+、CD79a+和类胰蛋白酶+细胞，所有这些都可能影响细胞结构、周围微环境的组织结构，并在子宫内膜异位症病灶中引起癌前甚至恶性变化。
