Department of Pathology, Stanford Healthcare, Stanford, California.
Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, California.
Fertil Steril. 2022 Oct;118(4):787-794. doi: 10.1016/j.fertnstert.2022.07.011.
To assess the impact of menstrual cycle phase on the detection of plasma cells.
A retrospective cohort study.
Fertility clinic.
PATIENT(S): Biopsies from 157 patients met criteria for inclusion, 91 in the follicular phase and 60 in the luteal phase. Patient groups were similar in body mass index and number of previous live births; however, differed in terms of age, infertility history, and biopsy indication.
Endometrial biopsies from patients at a fertility clinic from 2018-2020 were retrospectively reviewed. Biopsies were excluded if patients had a previous chronic endometritis diagnosis, abnormal uterine cavity or were on hormone therapy. Each case was reviewed by a gynecologic pathologist for plasma cells by hematoxylin and eosin and CD138 staining. Demographic and clinical data were collected. Continuous variables were compared using Welch t test and Wilcoxon's rank sum test, and categorical variables using Pearson's χ test. Logistic regression was used to calculate odds ratio and 95% confidence intervals for the association between the presence of plasma cells and cycle phase. Multinomial logistic regression was used to estimate the odds ratios for nominal outcomes. Pathology reports were reviewed. Plasma cell enumeration using hematoxylin and eosin-stained sections and CD138 immunohistochemical stains (performed at the time of biopsy by a gynecologic pathologist) was recorded.
MAIN OUTCOME MEASURE(S): Presence and density of plasma cells.
RESULT(S): We found a higher likelihood of finding plasma cells in the follicular than in luteal phase (59.3% vs. 19.7%). There was a higher likelihood of finding plasma cells in the early (cycle days 5-8, 29 cases or 76.3% of cases with plasma cells) than in the late follicular phase (cycle days 9-14, 25 cases or 47.2%). There was a higher density of plasma cells in the follicular phase group than in the luteal phase group (25.3% vs. 1.5% scattered and 13.2% vs. 0 clusters).
CONCLUSION(S): Plasma cells are more likely to be present during the follicular phase compared with the luteal phase and in the early compared with the late follicular phase. Further studies are needed to identify the optimal timing of biopsy to standardize the diagnosis.
评估月经周期阶段对浆细胞检测的影响。
回顾性队列研究。
生育诊所。
符合纳入标准的 157 名患者的活检，91 例在卵泡期，60 例在黄体期。患者组在体重指数和既往活产数方面相似；然而，在年龄、不孕史和活检指征方面存在差异。
回顾性分析 2018-2020 年生育诊所患者的子宫内膜活检。如果患者有慢性子宫内膜炎诊断、子宫腔异常或正在接受激素治疗，则排除活检。每位患者均由妇科病理学家通过苏木精和伊红及 CD138 染色进行浆细胞检查。收集人口统计学和临床数据。连续变量采用 Welch t 检验和 Wilcoxon 秩和检验进行比较，分类变量采用 Pearson χ 检验。采用 logistic 回归计算浆细胞存在与周期阶段之间的关联的比值比和 95%置信区间。采用多项逻辑回归估计名义结局的比值比。审查病理报告。记录苏木精和伊红染色切片和 CD138 免疫组织化学染色的浆细胞计数（由妇科病理学家在活检时进行）。
浆细胞的存在和密度。
我们发现卵泡期比黄体期更有可能发现浆细胞（59.3%比 19.7%）。在早期（周期第 5-8 天，29 例或有浆细胞的病例中 76.3%）比晚期卵泡期（周期第 9-14 天，25 例或 47.2%）更有可能发现浆细胞。卵泡期组浆细胞密度高于黄体期组（25.3%比 1.5%散在和 13.2%比 0 簇）。
与黄体期相比，浆细胞在卵泡期更有可能存在，与晚期卵泡期相比，在早期卵泡期更有可能存在。需要进一步研究以确定活检的最佳时机，以标准化诊断。
