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Published in: Archives of Gynecology and Obstetrics 5/2010

01-05-2010 | Original Article

Different HLA-DR expression in endometriotic and adenomyotic lesions: correlation with transvaginal ultrasonography findings

Authors: E. E. Koumantakis, J. G. Panayiotides, A. G. Goumenou, E. Ch. Ziogos, A. Margariti, V. Kalapothaki, Ioannis M. Matalliotakis

Published in: Archives of Gynecology and Obstetrics | Issue 5/2010

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Abstract

Objective

Human leukocyte antigen-DR (HLA-DR) has been implicated in eutopic and ectopic glandular epithelial cells in endometriosis. We investigated the expression of HLA-DR in endometriotic and adenomyotic tissues within the stromal and glandular cells. Moreover, we correlate the HLA-DR expression according the transvaginal ultrasonography findings.

Methods

We studied operative and pathologic reports of 113 women who underwent laparoscopic or laparotomy treatment of endometrioma or adenomyosis. Tissues from 51 women with endometrioma and 62 women with adenomyosis were retrospectively evaluated. The distribution and intensity of the HLA-DR immunostaining was assessed using electron microscopy. Pathologic finding of the uterine junction zone and the size of endometrioma were evaluated with the laparoscopic results and the ultrasound findings.

Results

In adenomyosis tissues, the percentage of HLA-DR cells expression was significantly higher in stromal cells (83.9%) compared to glandular cells (25.8%), (p < 0.001). The number of HLA-DR-positive endometriotic glandular cells was significantly higher than the total glandular adenomyotic cells (p < 0.005). HLA-DR-positive cells was significantly different between stromal (p < 0.016) and glandular cells (p < 0.044) in each side of endometrioma. Finally, HLA-DR-positive percentage cells were significantly more frequent in the secretory phase than the proliferative in stromal and glandular cells in both groups.

Conclusion

HLA-DR antigen expression in endometrium and adenomyotic tissues. However, HLA-DR expression is distributed preferentially in glandular epithelial cells in endometrioma and in the adenomyotic stroma. In both groups the HLA-DR expression was significantly higher in the secretory phase than the proliferative or glandular and stroma cells. Larger perspective studies are needed to establish the expression of HLA antigens in immune reactions which occur in adenomyosis and endometriosis.
Literature
1.
go back to reference Sampson JA (1924) Benign and malignant endometrial implants in peritoneal cavity and their relation to certain ovarian tumors. Surg Gynecol Obstet 38:287 Sampson JA (1924) Benign and malignant endometrial implants in peritoneal cavity and their relation to certain ovarian tumors. Surg Gynecol Obstet 38:287
2.
go back to reference Liu DT, Hitchock A (1986) Endometriosis its association with retrograde menstruation, dysmenorrhea and tubal pathology. Br J Obstet Gynecol 93:859 Liu DT, Hitchock A (1986) Endometriosis its association with retrograde menstruation, dysmenorrhea and tubal pathology. Br J Obstet Gynecol 93:859
3.
go back to reference Matalliotakis IM, Cakmak H, Koumantakis EE, Margariti A, Neonaki M, Goumenou A (2009) Arguments for a left lateral predisposition of endometrioma. Fertil Steril 91(4):975CrossRefPubMed Matalliotakis IM, Cakmak H, Koumantakis EE, Margariti A, Neonaki M, Goumenou A (2009) Arguments for a left lateral predisposition of endometrioma. Fertil Steril 91(4):975CrossRefPubMed
4.
go back to reference Bird CC, McElin TW, Manalo-Estrela P (1972) The elusive adenomyosis of the uterus. Am J Obstet Gynecol 112:583PubMed Bird CC, McElin TW, Manalo-Estrela P (1972) The elusive adenomyosis of the uterus. Am J Obstet Gynecol 112:583PubMed
5.
6.
7.
go back to reference McCausland V, McCausland A (1998) The response of adenomyosis to endometrial ablation/resection. Hum reprod Update 4:350CrossRefPubMed McCausland V, McCausland A (1998) The response of adenomyosis to endometrial ablation/resection. Hum reprod Update 4:350CrossRefPubMed
8.
go back to reference Reinhotel C, Tafareli F, Wang L (1998) Imaging features of adenomyosis. Hum Reprod Update 4:337CrossRef Reinhotel C, Tafareli F, Wang L (1998) Imaging features of adenomyosis. Hum Reprod Update 4:337CrossRef
9.
go back to reference Devlieger R, D’ Hoghe T, Timmerman D (2003) Uterine adenomyosis in the infertility. Clinic Hum Reprod 9:139CrossRef Devlieger R, D’ Hoghe T, Timmerman D (2003) Uterine adenomyosis in the infertility. Clinic Hum Reprod 9:139CrossRef
10.
go back to reference Matalliotakis IM, Katsikis IK, Panidis DK (2005) Adenomyosis: what is the important on fertility? Curr Opin Obstet Gynecol 17:261CrossRefPubMed Matalliotakis IM, Katsikis IK, Panidis DK (2005) Adenomyosis: what is the important on fertility? Curr Opin Obstet Gynecol 17:261CrossRefPubMed
11.
go back to reference Tabibradeh SS, Bettica A, Gerber MA (1986) Variable expression of Ia antigens in human endometrioma and in chronic endometriosis. Am J Clin Pathol 86:153 Tabibradeh SS, Bettica A, Gerber MA (1986) Variable expression of Ia antigens in human endometrioma and in chronic endometriosis. Am J Clin Pathol 86:153
12.
go back to reference Yamamoto Y, Maeda N, Izumiya C, Kusume T (2008) Decreased human leucocyte antigen-DR expression in the lipid raft by peritoneal macrophages from women with endometriosis. Fertil Steril 89:52CrossRefPubMed Yamamoto Y, Maeda N, Izumiya C, Kusume T (2008) Decreased human leucocyte antigen-DR expression in the lipid raft by peritoneal macrophages from women with endometriosis. Fertil Steril 89:52CrossRefPubMed
13.
go back to reference Matalliotakis IM, Athanasakis I, Goumenou AG, Neonaki MA, Koumandakis EE, Vassiliadis S, Koumandakis EE (2001) The possible anti- inflammatory role of circulating human leucocyte antigen levels in women with endometriosis after treatment with danazol and leuprolin acetate depot. Med of Infl 10:75CrossRef Matalliotakis IM, Athanasakis I, Goumenou AG, Neonaki MA, Koumandakis EE, Vassiliadis S, Koumandakis EE (2001) The possible anti- inflammatory role of circulating human leucocyte antigen levels in women with endometriosis after treatment with danazol and leuprolin acetate depot. Med of Infl 10:75CrossRef
14.
go back to reference American Fertility Society (1985) Revised American Fertility Society classification of endometriosis. Fertil Steril 43:351 American Fertility Society (1985) Revised American Fertility Society classification of endometriosis. Fertil Steril 43:351
15.
go back to reference Fedele L, Branchi S, Dorta M et al (1992) Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis. Fertil Steril 58:94PubMed Fedele L, Branchi S, Dorta M et al (1992) Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis. Fertil Steril 58:94PubMed
16.
go back to reference Bohlman MC, Ensor RE, Sanders RC (1987) Sonographic findings in adenomyosis of the uterus. Am J Roentgenol 148:765 Bohlman MC, Ensor RE, Sanders RC (1987) Sonographic findings in adenomyosis of the uterus. Am J Roentgenol 148:765
17.
go back to reference Fleege J, Van Diest P, Baak J (1991) Reliability of quantitative pathological assessments standards and quality control. In: Baak JPA (ed) Manual of quantitative pathology in cancer diagnosis and prognosis. Spinger, Berlin, pp 151–181 Fleege J, Van Diest P, Baak J (1991) Reliability of quantitative pathological assessments standards and quality control. In: Baak JPA (ed) Manual of quantitative pathology in cancer diagnosis and prognosis. Spinger, Berlin, pp 151–181
18.
go back to reference Nunn R, Rose A (1990) Light microscopy. In: Bancroft J, Stevens A (eds) Theory and practice of histological techniques, 3rd edn. Churchill Livingstone, Edinburgh, pp 1–20 Nunn R, Rose A (1990) Light microscopy. In: Bancroft J, Stevens A (eds) Theory and practice of histological techniques, 3rd edn. Churchill Livingstone, Edinburgh, pp 1–20
19.
go back to reference Scotti S, Regidor PA, Schindler AE, Winterhager E (2000) Reduced proliferation and cell adhesion in endometriosis. Mol Hum Reprod 7:610CrossRef Scotti S, Regidor PA, Schindler AE, Winterhager E (2000) Reduced proliferation and cell adhesion in endometriosis. Mol Hum Reprod 7:610CrossRef
20.
go back to reference Ota H, Igarashi S, Hatazawa I, Tanaka T (1998) Is adenomyosis an immune disease? Hum Reprod Update 4:360CrossRefPubMed Ota H, Igarashi S, Hatazawa I, Tanaka T (1998) Is adenomyosis an immune disease? Hum Reprod Update 4:360CrossRefPubMed
21.
go back to reference Ota H, Igarashi S (1993) Expression of major histocompatibility complex class II antigen in endometriotic tissue in patients with endometriosis and adenomyosis. Fertil Steril 60:834–838PubMed Ota H, Igarashi S (1993) Expression of major histocompatibility complex class II antigen in endometriotic tissue in patients with endometriosis and adenomyosis. Fertil Steril 60:834–838PubMed
22.
go back to reference Ota H, Igarashi S, Tanakata T (1996) Expression of KLT cells and adhesion molecules in endometriotic tissue in patients with endometriosis and adenomyosis. Am J Reprod Immunol 35:477PubMed Ota H, Igarashi S, Tanakata T (1996) Expression of KLT cells and adhesion molecules in endometriotic tissue in patients with endometriosis and adenomyosis. Am J Reprod Immunol 35:477PubMed
23.
go back to reference Bulmer JN, Jones RK, Searle RF (1998) Intraepithelial leucocytes in endometriosis and adenomyosis: comparison of eutopic and ectopic endometrium with normal endometrium. Hum Reprod 13:2910PubMed Bulmer JN, Jones RK, Searle RF (1998) Intraepithelial leucocytes in endometriosis and adenomyosis: comparison of eutopic and ectopic endometrium with normal endometrium. Hum Reprod 13:2910PubMed
24.
go back to reference Weed JC, Arquembourg PC (1980) Endometriosis: can it produce an autoimmune response resulting in infertility? Clin Obstet Gynecol 23:885CrossRefPubMed Weed JC, Arquembourg PC (1980) Endometriosis: can it produce an autoimmune response resulting in infertility? Clin Obstet Gynecol 23:885CrossRefPubMed
25.
go back to reference Kreiner D, Fromowitz KB, Richardson DA (1986) Immunofluorescence associated with endometriosis and pelvic inflammatory disease. Fertil Steril 46:243PubMed Kreiner D, Fromowitz KB, Richardson DA (1986) Immunofluorescence associated with endometriosis and pelvic inflammatory disease. Fertil Steril 46:243PubMed
26.
go back to reference Koumantakis E, Matalliotakis I, Neonaki M, Froudarakis G, Georgoulias V (1994) Soluble serum interleukin-2 receptor, interleukin-6 and interleukin-1α in patients with endometriosis and in controls. Arch Gynecol Obstet 255:107CrossRefPubMed Koumantakis E, Matalliotakis I, Neonaki M, Froudarakis G, Georgoulias V (1994) Soluble serum interleukin-2 receptor, interleukin-6 and interleukin-1α in patients with endometriosis and in controls. Arch Gynecol Obstet 255:107CrossRefPubMed
27.
go back to reference Matalliotakis I, Vassiliadis S, Goumenou A, Fragouli Y, Athanassakis I (2008) Suggested markers for the diagnosis of endometriosis. Current women’s Health. Reviews 4.25 Matalliotakis I, Vassiliadis S, Goumenou A, Fragouli Y, Athanassakis I (2008) Suggested markers for the diagnosis of endometriosis. Current women’s Health. Reviews 4.25
28.
go back to reference Mahutte NG, Matalliotakis IM, Goumenou AG, Koumandakis GE, Vassiliadis S, Arici A (2004) Elevations in peritoneal fluid macrophage migration inhibitory factor are independent of the depth of invasion or stage of endometriosis. Fertil Steril 82:97CrossRefPubMed Mahutte NG, Matalliotakis IM, Goumenou AG, Koumandakis GE, Vassiliadis S, Arici A (2004) Elevations in peritoneal fluid macrophage migration inhibitory factor are independent of the depth of invasion or stage of endometriosis. Fertil Steril 82:97CrossRefPubMed
29.
go back to reference Hassa H, Tanit HM, Tekin B, Kirimaz SD, Sahin Mutla F (2008) Cytokine and immune cells levels in peritoneal fluid and peripheral blood of women with early- and late- staged endometriosis. Arch Gynecol Obstet 279:891–895CrossRefPubMed Hassa H, Tanit HM, Tekin B, Kirimaz SD, Sahin Mutla F (2008) Cytokine and immune cells levels in peritoneal fluid and peripheral blood of women with early- and late- staged endometriosis. Arch Gynecol Obstet 279:891–895CrossRefPubMed
Metadata
Title
Different HLA-DR expression in endometriotic and adenomyotic lesions: correlation with transvaginal ultrasonography findings
Authors
E. E. Koumantakis
J. G. Panayiotides
A. G. Goumenou
E. Ch. Ziogos
A. Margariti
V. Kalapothaki
Ioannis M. Matalliotakis
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 5/2010
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-009-1168-z

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