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Journal articles on the topic 'Endometrium'
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Arai, Y., and M. Nishida. "Differential diagnosis between normal endometrium and endometrial hyperplasia with immunostaining cytology using anti-LeY monoclonal antibody." International Journal of Gynecologic Cancer 13, no. 1 (2003): 42–46. http://dx.doi.org/10.1136/ijgc-00009577-200301000-00008.
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We have previously reported that both endometrial cancer and endometrial hyperplasia stain positively for the anti-LeY monoclonal antibody, whereas normal endometrium does not. Endometrial hyperplasia is a premalignant change associated with the eventual development of endometrial carcinoma. However, it can be difficult to differentiate hyperplasia from normal endometrium in cytology. This study illustrates the use of immunocytochemical cytology using anti-LeY monoclonal antibody to differentiate between endometrial hyperplasia and normal endometrium. Immunostaining using anti-LeY monoclonal antibody was performed on cytologic specimens obtained from 17 normal endometria, 25 endometria with endometrial hyperplasia, and 13 endometria with endometrial carcinoma. All normal endometria displayed negative staining for anti-LeY monoclonal antibody, whereas all endometria with endometrial carcinoma displayed positive staining. Of the endometrial hyperplasia cases, 21 displayed positive staining. However, four displayed negative staining due to the small number of cells available for diagnosis. We believe that immunostaining cytology using anti-LeY monoclonal antibody is a useful method for differentiating between normal endometrium and endometrial hyperplasia.
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Suda, Kazuaki, Hirofumi Nakaoka, Kosuke Yoshihara, Tatsuya Ishiguro, Sosuke Adachi, Hiroaki Kase, Teiichi Motoyama, Ituro Inoue, and Takayuki Enomoto. "Different mutation profiles between epithelium and stroma in endometriosis and normal endometrium." Human Reproduction 34, no. 10 (October 2019): 1899–905. http://dx.doi.org/10.1093/humrep/dez155.
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Abstract STUDY QUESTION Are there common mutation profiles between epithelial and stromal cells in ovarian endometriotic tissue and the normal endometrium? SUMMARY ANSWER Our study revealed no common mutations between epithelial and stromal cells in ovarian endometriotic tissue and the normal endometrium. WHAT IS KNOWN ALREADY Epithelial cells in both ovarian endometriotic tissue and the normal endometrium harbor somatic mutations in cancer-associated genes such as phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) and KRAS proto-oncogene, GTPase (KRAS). STUDY DESIGN, SIZE, DURATION We performed a retrospective study to identify the mutation profiles of stromal cells in endometriotic tissue and the normal endometrium. We collected 11 endometriotic stroma samples and 10 normal endometrial stroma samples between 2013 and 2017 at a tertiary care center. PARTICIPANTS/MATERIALS, SETTING, METHODS The laser microdissection method was used to obtain stromal cells in ovarian endometriotic and normal endometrial tissues from patients with ovarian endometriosis and/or other non-invasive gynecological diseases. Target gene sequencing was performed to assess and compare the mutation profiles of stromal cells with those of epithelial cells obtained in our previous study. For target gene sequencing, 76 genes were selected based on previous genomic analyses for ovarian endometriosis, normal endometrium, endometriosis-related ovarian cancer and endometrial cancer. MAIN RESULTS AND THE ROLE OF CHANCE Stromal samples in ovarian endometrioma and normal endometrium harbor somatic mutations (18 mutations in 11 endometriosis samples and 16 mutations in 10 normal endometrial samples) but did not share any mutations with paired epithelial samples. The mutant allele frequency of stromal samples was significantly lower than that of epithelial samples in ovarian endometrioma (P = 6.0 × 10-11) and normal endometrium (P = 1.4 × 10-7). LIMITATIONS, REASONS FOR CAUTION The number of genes evaluated in the mutational analysis was limited. Additionally, the functional roles of somatic mutations in stromal cells remain unclear. WIDER IMPLICATIONS OF THE FINDINGS Different mutation profiles between paired epithelial and stromal cells in both ovarian endometrioma and normal endometrium suggest that origins of epithelial and stromal cells would be independent of each other in both normal endometrium and ovarian endometrioma; however, the theory of epithelial-mesenchymal transition is proposed in ovarian endometrioma. STUDY FUNDING/COMPETING INTEREST(S) This work was supported in part by the Japan Society for the Promotion of Science KAKENHI grant number JP15H02373 (Grant-in-Aid for Scientific Research A for I.I.), JP16H06267 (Grant-in-Aid for Young Scientists A for K.Y.), JP17K08688 (Grant-in-Aid for Scientific Research C for H.N.) and JP16H06279 (Grant-in-Aid for Scientific Research on Innovative Areas—Platforms for Advanced Technologies and Research Resources for H.N. and K.Y). There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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ÖZKARA, S. K., and A. ÇORAKÇI. "FHIT expression in neoplastic, hyperplastic, and normal endometrium." International Journal of Gynecologic Cancer 15, no. 6 (November 2005): 1081–88. http://dx.doi.org/10.1136/ijgc-00009577-200511000-00011.
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Fragile histidine triad (FHIT), a candidate of tumor suppressor protein, expression was examined on paraffin-embedded specimens in proliferative, secretory, hyperplastic, and neoplastic human endometrium by immunohistochemistry. The results of FHIT immunoreactivity in endometrial carcinomas were compared with prognostic indicators as well as with p53 overexpression. Forty-four cases of endometrial carcinoma, 30 normal functional (15 proliferative, 15 secretory), and 24 hyperplastic endometrium (12 without atypia, 12 with atypia) specimens were studied using polyclonal FHIT antibody. The streptavidin–biotin–peroxidase detection system was used, and the intensity and the distribution of immunoreactivity were evaluated semiquantitatively. There were no significant differences in FHIT expression in the proliferative, secretory, hyperplastic, either with or without atypia, or carcinomatous endometria. No significant difference in FHIT expression of endometrial carcinomas was detected when prognostic parameters or p53 overexpression were considered. Loss or reduced FHIT expression was not found to predict disease-free or cumulative survivals. This study showed that loss or reduction in FHIT protein expression is present in normal functional and hyperplastic endometria as well as in neoplastic endometrium. FHIT protein seems not to be involved directly in endometrial carcinogenesis, but rather, it regulates cell proliferation both in physiologic and in pathologic conditions of endometrium.
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Kathuria, Priyanka. "#331 : Bilateral Endometriomas Masquerading Synchronous Endometrial and Ovarian Cancer (SEOC) in an Infertile Female." Fertility & Reproduction 05, no. 04 (December 2023): 512–13. http://dx.doi.org/10.1142/s2661318223742753.
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Background and Aims: Endometriomas are diagnosed in clinical practice by imaging (mostly ultrasound) in females presenting with infertility. CA-125 level is an adjuvant investigation which may be indicative of endometriosis. A few research questions that are yet to be answered. Is ultrasound a sufficient modality to diagnose endometrioma? Is there any cut off as far as the measurement of endometrioma is concerned to step up the imaging modality to MRI? Synchronous endometrial and ovarian cancer (SEOC) is a rare phenomenon with an incidence of 1.4 - 3.8%. Mostly in SEOC, the ovarian endometroid carcinoma arises in background of endometriosis with endometrial carcinoma of lower stage and grade in premenopausal age group. Method: A 32-year-old female with Severe Dysmenorrhea and Secondary infertility had clinical evidence of bilateral endometriomas of 4-5 cm on ultrasound. She underwent hysterolaparoscopy. On hysteroscopy, endometrium was polypoidal and vascular, looking suspicious for malignancy. Hence endometrial biopsy was taken. On laparoscopy, B/L ovaries were enlarged, multiloculated, solid-cystic with granular surface and adhered in POD, decision for staging laparotomy with frozen section was taken. Frozen section was suggestive of Borderline tumor. Eventually, fertility sparing surgical staging was done (BSO + infracolic omentectomy + peritoneal biopsies). Peritoneal cytology was negative for malignant cells. Results: Histopathological examination revealed Endometriod adenocarcinoma grade 1a/1a in both endometrial and ovarian components with no involvement of omentum and peritoneum. Immunohistochemistry demonstrated P53 to be moderately positive in endometrium and strongly positive in ovary, whereas ER, PR was positive in both tumors of endometrium and ovary and WT-1 negative in ovaries. Hence diagnosed as SEOC and not metastatic tumor. Mirena was inserted in follow up and repeat biopsy is awaited. Conclusion: Suspicion of ovarian endometroid carcinoma must born in mind in cases with large bilateral endometriomas with long-standing endometriosis.
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Waiyaput, Wanwisa, Ongarj Bovornsakulvong, Srithean Lertvikool, and Areepan Sophonsritsuk. "The Effect of Combined Oral Contraceptive Pills on Beclin-1 and LC3B Transcript Levels in Ovarian Endometrioma." BioMed Research International 2021 (June 28, 2021): 1–6. http://dx.doi.org/10.1155/2021/5519538.
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Background. Autophagy is likely altered in patients with endometriosis. Ovarian steroid hormones seem to affect this changing of the autophagic process. Objective. To study the effect of combined oral contraceptive (COC) pills on the expression of autophagic-related gene BECN1 and LC3B in the ectopic and eutopic endometria of patients with endometriosis. Material and Methods. The present quasiexperimental study recruited 36 women (18–45 years old) with endometrioma and nonendometrioma who were scheduled for surgery. Patients with endometrioma were randomly assigned to either a no-treatment group ( n = 12 ) or a COC group ( n = 12 ). The COC group was prescribed a daily oral pill composed of 3 mg drospirenone and 0.03 mg ethinyl estradiol for 6 weeks before surgery. The control group ( n = 12 ) was composed of women without endometrioma. Ectopic endometriotic and endometrium tissues were collected from the no-treatment and COC groups, whereas the only endometrium was collected from the control group. These tissues were used for real-time PCR to measure the expression of the BECN1 and LC3B genes. Results. The baseline demographic data were not different among the three groups. The BECN1 gene expression in endometrium tissue in the COC group was significantly less than that in the no-treatment and control groups ( P = 0.011 and 0.029, respectively). No significant difference of endometriotic cyst BECN1 and LC3B gene expression was found between COC and no treatment. Conclusions. Oral COC pills for 6 weeks continuously before surgery decreased the eutopic endometrial expression (mRNA) of the BECN1 gene compared to those from healthy normal women and nontreated patients with an endometriotic cyst. The change in the expression of autophagy-related genes was more distinct in eutopic than ectopic endometria. This trial is registered with TCTR20170720002. Registered and enrolled the first patient on 20 July 2017.
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Liu, Xiaorui, Lei Zhang, Jiuzeng Cui, Sicheng Che, Yuexia Liu, Yue Zhang, Binyun Cao, and Yuxuan Song. "The mRNA and lncRNA landscape of the non-pregnant endometrium during the oestrus cycle in dairy goat." Animal Production Science 59, no. 10 (2019): 1803. http://dx.doi.org/10.1071/an18426.
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Cyclic changes in the endometrium are essential for embryo implantation in mammals; many studies report that such changes constitute a complex process involving numerous molecular mediators. In the present study, goat endometria at oestrus Day 5 and oestrus Day 15 were selected to systematically analyse the transcriptome using strand-specific Ribo-Zero RNA sequencing. Over 120 million high-quality paired-end reads were generated and 440400 transcripts were identified in the endometrial tissue of dairy goats. In total, 489 differentially expressed mRNAs and 854 differentially expressed long non-coding RNAs were identified when comparing the endometrium at goat endometria at oestrus Day 5 and oestrus Day 15. Neurotensin was found to play a potentially important role in the non-pregnant goat endometrium during the oestrus cycle. Furthermore, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes analyses of the cis-target genes of the differentially expressed long non-coding RNAs showed that GO:0005198 (structural molecule activity) and ko04510 (focal adhesion) might be involved in cyclic endometrial changes. Taken together, the resulting transcriptomic profiles elucidate global trends in mRNA and lncRNA expression in non-pregnant endometria during the oestrus cycle in dairy goats.
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Quddus, M. Ruhul, Predrag Latkovich, William J. Castellani, C. James Sung, Margaret M. Steinhoff, Robert C. Briggs, and Roberto N. Miranda. "Expression of Cyclin D1 in Normal, Metaplastic, Hyperplastic Endometrium and Endometrioid Carcinoma Suggests a Role in Endometrial Carcinogenesis." Archives of Pathology & Laboratory Medicine 126, no. 4 (April 1, 2002): 459–63. http://dx.doi.org/10.5858/2002-126-0459-eocdin.
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Abstract Context.—Endometrioid carcinoma is often preceded by characteristic histopathologic lesions known as endometrial hyperplasia. Estrogen appears to be involved in the development of endometrioid carcinoma. Other mechanisms of endometrial carcinogenesis include mutations in p53 and PTEN tumor suppressor genes and overexpression of cyclin D1. However, the pattern of cyclin D1 expression is not well defined in normal, hyperplastic, neoplastic, and metaplastic endometrium. Design.—Cyclin D1 immunohistochemical analysis was used to evaluate 108 fixed, paraffin-embedded endometrial biopsy specimens and uterine resections obtained from 108 patients. Specimens included proliferative and secretory endometria, simple and complex hyperplastic lesions, and endometrioid adenocarcinoma. Normal and metaplastic surface epithelia were also evaluated independently of glandular morphologic features. Results.—Cyclin D1 was significantly overexpressed in glands with complex hyperplasia and endometrioid adenocarcinoma compared with proliferative or secretory endometrium and simple hyperplasia. Significant overexpression was also noted in papillary, syncytial, and squamous metaplasias compared with normal surface epithelium or epithelium with tubal metaplasia. Conclusion.—Overexpression of cyclin D1 increases from normal endometrium to hyperplasia and carcinoma, suggesting that it may play a role in endometrial carcinogenesis. Overexpression of cyclin D1 in endometrial glands was independent from overexpression of cyclin D1 in surface metaplastic epithelium.
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S.M. Mammadova. "Postmenopauzal dövrdə endometriumun, yumurtalıqların, uşaqlıq boynunun xərçəngində reproduktiv exoqrafik göstəricilərinin xüsusiyyətləri." Actual Questions of Modern Gynecology and Perinatology 7, no. 1 (February 6, 2021): 9–14. http://dx.doi.org/10.28942/mgpam.v7i1.1.
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Tədqiqatın məqsədi: endometrial, yumurtalıq və uşaqlıq boynu xərçəngi olan xəstələrdə reproduktiv sistem orqanlarının ekoqrafik göstəricilərinin xüsusiyyətlərini öyrənmək.Material və tədqiqat metodları. Reproduktiv sistem orqanlarının xərçəngi olan 35 xəstə müayinə edildi. Bunlardan 20-si (% 57.1) klinik, funksional, hormonal, biyokimyəvi, radioloji, morfoloji tədqiqat metodlarına əsasən endometrial xərçəngə, 7-də (% 20) yumurtalıq xərçəngi, 8-də (% 22.9) uşaqlıq boynu xərçəngi var.Tədqiqat nəticələri. Tədqiqat nəticəsində, postmenopozal dövrdə endometrium xərçəngi olan xəstələrdə, serviksin ekoqrafik ölçülərində komplikasiyasız postmenopozal dövrü olan qadınlarda analoji göstəricilərlə müqayisədə azalma və patoloji artım olduğu aşkar edildi. uşaqlıq boşluğunda bir təhsil olması ilə endometriumun qalınlığı. Yumurtalıq xərçəngində, yumurtalıqların ekografik göstəricilərində və uşaqlıq boynu xərçəngində endometrium qalınlığında statistik olaraq əhəmiyyətli bir artım olmuşdur.Uşaqlıq boynu xərçəngində uşaqlıq və yumurtalıqların ekoqrafik göstəriciləri, endometriumun qalınlığının artması və qeyri-bərabər konturlarla homojen olmayan bir tutarlılığın əmələ gəlməsi ilə postmenopozal dövrünün ağırlaşmamış gedişatının oxşar göstəriciləri idi.
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Bukulmez, Orhan, Daniel B. Hardy, Bruce R. Carr, R. Ann Word, and Carole R. Mendelson. "Inflammatory Status Influences Aromatase and Steroid Receptor Expression in Endometriosis." Endocrinology 149, no. 3 (November 29, 2007): 1190–204. http://dx.doi.org/10.1210/en.2007-0665.
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Aberrant up-regulation of aromatase in eutopic endometrium and implants from women with endometriosis has been reported. Aromatase induction may be mediated by increased cyclooxygenase-2 (COX-2). Recently, we demonstrated that progesterone receptor (PR)-A and PR-B serve an antiinflammatory role in the uterus by antagonizing nuclear factor κB activation and COX-2 expression. PR-C, which antagonizes PR-B, is up-regulated by inflammation. Although estrogen receptor α (ERα) is implicated in endometriosis, an antiinflammatory role of ERβ has been suggested. We examined stage-specific expression of aromatase, COX-2, ER, and PR isoform expression in eutopic endometrium, implants, peritoneum, and endometrioma samples from endometriosis patients. Endometrial and peritoneal biopsies were obtained from unaffected women and those with fibroids. Aromatase expression in eutopic endometrium from endometriosis patients was significantly increased compared with controls. Aromatase expression in endometriosis implants was markedly increased compared with eutopic endometrium. Aromatase mRNA levels were increased significantly in red implants relative to black implants and endometrioma cyst capsule. Moreover, COX-2 expression was increased in implants and in eutopic endometrium of women with endometriosis as compared with control endometrium. As observed for aromatase mRNA, the highest levels of COX-2 mRNA were found in red implants. The ratio of ERβ/ERα mRNA was significantly elevated in endometriomas compared with endometriosis implants and eutopic endometrium. Expression of PR-C mRNA relative to PR-A and PR-B mRNA was significantly increased in endometriomas compared with eutopic and control endometrium. PR-A protein was barely detectable in endometriomas. Thus, whereas PR-C may enhance disease progression, up-regulation of ERβ may play an antiinflammatory and opposing role.
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Song, Gwonhwa, Thomas E. Spencer, and Fuller W. Bazer. "Cathepsins in the Ovine Uterus: Regulation by Pregnancy, Progesterone, and Interferon Tau." Endocrinology 146, no. 11 (November 1, 2005): 4825–33. http://dx.doi.org/10.1210/en.2005-0768.
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Cathepsins (CTS) are peptidases that have biological roles in degrading extracellular matrix, catabolism of intracellular proteins, and processing of prohormones. Expression of CTSB, CTSD, CTSH, CTSK, CTSL, CTSS, and CTSZ genes was detected in the endometria of cyclic and early pregnant ewes with distinct temporal and spatial expression patterns. In the d 18 and 20 conceptus, expression of CTSB, CTSD, CTSL, and CTSZ mRNA was detected in the trophectoderm. Of particular note, CTSL mRNA was the most abundant CTS mRNA in the ovine endometrium and detected only in the luminal epithelium and superficial glandular epithelium of cyclic and pregnant ewes. CTSL mRNA increased 8-fold between d 10 and 18 in endometria of pregnant ewes, whereas it declined between d 14 and 16 in cyclic ewes. CTSL protein was also detected in conceptus trophectoderm, and pro-CTSL was detected in uterine flushings from ewes between d 12 and 16 of pregnancy. In ovariectomized and catheterized ewes, CTSL mRNA in the endometrium was increased by progesterone and intrauterine injections of ovine interferon (IFN)τ. Other endometrial CTS genes were also regulated by progesterone alone (CTSB, CTSK, CTSS, and CTSZ) or progesterone and IFNτ (CTSH, CTSK, CTSS, and CTSZ). These results indicate that CTS of endometrial and conceptus origin may regulate endometrial remodeling and conceptus implantation, endometrial CTS genes are regulated by ovarian and placental hormones, and CTSL is a novel IFNτ-stimulated gene expressed only in luminal epithelium and superficial glandular epithelium of the endometrium.
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Jasiński, Tomasz, Łukasz Zdrojkowski, Graça Ferreira-Dias, Ewa Kautz, Edyta Juszczuk-Kubiak, and Małgorzata Domino. "Molecular Mechanism of Equine Endometrosis: The NF-κB-Dependent Pathway Underlies the Ovarian Steroid Receptors’ Dysfunction." International Journal of Molecular Sciences 23, no. 13 (July 1, 2022): 7360. http://dx.doi.org/10.3390/ijms23137360.
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Endometrosis is a frequently occurring disease decreasing mares’ fertility. Thus, it is an important disease of the endometrium associated with epithelial and stromal cell alterations, endometrium gland degeneration and periglandular fibrosis. Multiple degenerative changes are found in uterine mucosa, the endometrium. However, their pathogenesis is not well known. It is thought that nuclear factor-κB (NF-κB), a cell metabolism regulator, and its activation pathways take part in it. The transcription of the profibrotic pathway genes of the NF-κB in fibrotic endometria differed between the follicular (FLP) and mid-luteal (MLP) phases of the estrous cycle, as well as with fibrosis progression. This study aimed to investigate the transcription of genes of estrogen (ESR1, ESR2) and progesterone receptors (PGR) in equine endometria to find relationships between the endocrine environment, NF-κB-pathway, and fibrosis. Endometrial samples (n = 100), collected in FLP or MLP, were classified histologically, and examined using quantitative PCR. The phase of the cycle was determined through the evaluation of ovarian structures and hormone levels (estradiol, progesterone) in serum. The transcription of ESR1, ESR2, and PGR decreased with the severity of endometrial fibrosis and degeneration of the endometrium. Moreover, differences in the transcription of ESR1, ESR2, and PGR were noted between FLP and MLP in the specific categories and histopathological type of equine endometrosis. In FLP and MLP, specific moderate and strong correlations between ESR1, ESR2, PGR and genes of the NF-κB pathway were evidenced. The transcription of endometrial steroid receptors can be subjected to dysregulation with the degree of equine endometrosis, especially in both destructive types of endometrosis, and mediated by the canonical NF-κB pathway depending on the estrous cycle phase.
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Elmore, Lynne W., Kelly Domson, Jonathan R. Moore, Michael Kornstein, and R. Tucker Burks. "Expression of c-Kit (CD117) in Benign and Malignant Human Endometrial Epithelium." Archives of Pathology & Laboratory Medicine 125, no. 1 (January 1, 2001): 146–51. http://dx.doi.org/10.5858/2001-125-0146-eockci.
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Abstract Background.—The proto-oncogene c-kit encodes a tyrosine kinase receptor (CD117) with a molecular weight of 145 kd. Previous studies, predominantly utilizing immunohistochemistry, have led to contradictory findings regarding the expression of CD117 in the endometrium. To help resolve this issue, we analyzed a series of benign and malignant endometrial tissues using both immunohistochemistry and Western blot analysis. Objective.—To examine the expression of CD117 in benign and malignant human endometrial tissues. Methods.—The expression of CD117 in 35 benign endometrial tissues (7 hyperplastic, 14 proliferative, 14 secretory) and 10 endometrioid carcinomas was investigated by immunohistochemistry (clone K45 monoclonal antibody). Immunoprecipitation (clone K69 monoclonal antibody) followed by Western blotting (clone K45 monoclonal antibody and clone 1.D9.3D6 monoclonal antibody) was performed to confirm CD117 expression. Results.—Fifty-seven percent of the hyperplasias, 93% of proliferative endometria, and 79% of secretory endometria immunostained positively for CD117. In benign endometria, epithelial staining tended to be more intense in the hyperplastic and proliferative endometria as compared to the secretory endometria, whereas endometrial stromal cells were not immunoreactive. Of the 10 frozen endometrial tissues analyzed by immunohistochemistry, 4 of 9 endometrioid carcinomas and a single case of an endometrioid polyp developing in association with a carcinoma expressed CD117. Immunoprecipitation followed by Western blot analysis confirmed expression of full-length CD117 in an endometrial polyp and carcinoma, and revealed a correlation between levels of immunoprecipitated CD117 and immunohistochemical staining intensity. Conclusions.—Benign and malignant endometrial tissues express CD117. Our data suggest (a) a possible relationship between estrogen and CD117 expression in benign endometrium and (b) potential involvement of this growth factor receptor in endometrial carcinogenesis.
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R., Sajeetha Kumari, and Anuradha M. "Endometrial patterns in abnormal uterine bleeding: a retrospective study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 11 (October 28, 2017): 4966. http://dx.doi.org/10.18203/2320-1770.ijrcog20175009.
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Background: Abnormal uterine bleeding (AUB) is a common reason for women of all ages to consult their gynecologist and is one of the most common debilitating menstrual problems ending up in hysterectomy in developing countries. The aim of the present study was to determine the clinical spectrum and frequency of pathologies in endometrial biopsy of patients with AUB in our population. We also tried to observe the incidence of various pathologies in different age groups presenting with abnormal uterine bleeding.Methods: The study was conducted in SRM Medical College Hospital and Research Centre, Tamil Nadu over a period of eight months. This was a retrospective study done on 217 patients presenting with abnormal uterine bleeding who underwent endometrial sampling in our hospital. The pattern of endometrial changes were studied and classified.Results: Age of the patients in our study ranged from 25 years to 68 years with maximum in the age group of 41-50 years. The commonest clinical feature was menorrhagia followed by metrorrhagia. Evaluation of the endometrium revealed various histopathological patterns like proliferative endometrium, secretory endometrium, disordered proliferative endometrium, pill endometrium, shedding endometrium, simple hyperplasia, complex hyperplasia, atrophic endometrium, endometrial polyp, carcinoma endometrium etc.The incidence of malignancy was 1.84%.Conclusions: Histopathological examination of the endometrium showed a wide spectrum of pathological changes ranging from normal endometrium to malignancy thus emphasizing the importance of endometrial sampling as an important diagnostic tool in the management of abnormal uterine bleeding. Accurate analysis of endometrial samplings is the key to effective therapy and optimal outcome.
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Mandic, Aljosa, and Tamara Vujkov. "Endometrial cancer: Diagnostic methods in postmenopausal vaginal bleeding." Archive of Oncology 11, no. 2 (2003): 97–101. http://dx.doi.org/10.2298/aoo0302097m.
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Postmenopausal vaginal bleeding (PMB) is the leading symptom of endometrial cancer. More than 70% of patients with endometrial cancer are postmenopausal. Despite PMB as a leading symptom in diagnosis of endometrial cancer, PMB could be caused by some benign processes in endometrium such as hyperplasia and focal endometrial disease, such as a polyp. The golden standard for histological evaluation of the endometrium is curettage. Transvaginal ultrasound (TVS) and measurement of endometrium thickness is also one of the favored methods in the last decade. Sonographic imaging of the endometrium can be extremely helpful, because endometrial cancer is nearly always associated with thickening and heterogeneity of the endometrium except in case of atrophy-associated adenocarcinoma of the endometrium, which is not associated with thickening. Hysteroscopy found place as a favored method in diagnosis of focal endometrial lesions. Saline infusion sonohysterography (SIS) is a relatively new imaging procedure. The SIS will show whether the endometrium is diffusely thickened, in which case curettage would be the next step, or focally thickened, in which case hysteroscopy with biopsy would be the next step. Combination of some diagnostic procedures, such as TVS, SIS, hysteroscopy, endometrial biopsy and curettage, should decrease false positive and false negative results which may affect the correct diagnosis and treatment.
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NG, Ernest Hung Yu, and Pak Chung HO. "Ultrasound Assessment of Endometrial Receptivity in in vitro Fertilization Treatment." Donald School Journal of Ultrasound in Obstetrics and Gynecology 4, no. 2 (2010): 179–88. http://dx.doi.org/10.5005/jp-journals-10009-1141.
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Abstract Ultrasonography of the endometrium is a noninvasive way to evaluate the chance of successful implantation during in vitro fertilization treatment. Ultrasound parameters of endometrial receptivity include endometrial thickness, endometrial pattern, endometrial volume, Doppler studies of uterine vessels and the endometrium. Endometrial thickness, pattern and volume are not predictive of pregnancy. A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. Doppler study of uterine arteries does not reflect the actual blood flow to the endometrium. Endometrial and subendometrial vascularity can be more objectively measured with three-dimensional power Doppler ultrasound. However, the role of endometrial and subendometrial vascularity in predicting pregnancy of in vitro fertilization treatment remains controversial.
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Ferreira-Dias, G. M., L. G. Nequin, and S. S. King. "Morphologic comparisons among equine endometrium categories I, II, and III, using light and transmission electron microscopy." American Journal of Veterinary Research 60, no. 1 (January 1, 1999): 49–55. http://dx.doi.org/10.2460/ajvr.1999.60.01.49.
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Abstract Objective To evaluate whether the pathologic changes observed by light microscopy in endometrium of categories II and III were reflected by cellular changes and to describe differences in the endometrial cell ultrastructure during estrus and diestrus. Animals 18 healthy mares. Procedure Endometrial tissues biopsied during the physiologic breeding season were categorized, using light microscopy, and were studied, using transmission electron microscopy (TEM). Results Using TEM, glycogen granules were associated with giant mitochondria for all endometrial types during diestrus. Development of rough endoplasmic reticulum (RER) and Golgi apparatus suggested protein synthesis in the endometrial glands during diestrus. TEM did not reveal major ultrastructural differences, between endometrium of categories I and II. This was unlike differences identified by light microscopy. The most extensive pathologic changes were seen in category-III tissue (TEM and light microscopy). Category-III endometria had a large number of light cells with more degenerative structures and fewer organelles, and lacked cilia in the lumen of the glands. This tissue had extensive fibrotic tissue in the lamina propria and many inflammatory cells in most tissue layers. Conclusions The severe ultrastructural changes may be one of the many factors decreasing the fertility of mares with category-III, compared with category-1 and -2, endometrium. (Am J Vet Res 1999;60:49–55)
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Yotsumoto, Fusanori, Hideki Iwaguro, Yusuke Harada, Satoshi Sobajima, Takako Suwabe, and Shingo Miyamoto. "Adipose tissue-derived regenerative cells improve implantation of fertilized eggs in thin endometrium." Regenerative Medicine 15, no. 7 (July 2020): 1891–904. http://dx.doi.org/10.2217/rme-2020-0037.
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Aim: Embryo implantation and subsequent pregnancy depends on endometrial thickness. To investigate potential fertility strategies for women with thin endometrium, we explored the efficacy of adipose tissue-derived regenerative cells (ADRCs) on thin endometrium and embryo implantation in a mouse model. Materials & methods: ADRCs isolated from mouse subcutaneous fat were characterized by flow cytometry. Endometrium thickness, endometrial fibrosis, embryo implantation and angiogenesis factors were evaluated in uterine cavities of ethanol-induced thin endometrium mice with ADRC transplantation. Results: ADRCs included adipose-derived stem cells and some blood vessel component cells. ADRCs improved endometrial thickness, endometrial fibrosis and embryo implantation and augmented vascular endothelial growth factor expression in the mouse uterine. Conclusion: ADRCs may be a useful therapeutic strategy to improve fertility of women with thin endometrium.
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Brandão, Verônica, Juliana Meola, Sergio Garcia, Francisco Candido-dos-Reis, Omero Poli-Neto, Antonio Nogueira, and Julio Rosa-e-Silva. "Increased Expression Levels of Metalloprotease, Tissue Inhibitor of Metalloprotease, Metallothionein, and p63 in Ectopic Endometrium: An Animal Experimental Study." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 40, no. 11 (November 2018): 705–12. http://dx.doi.org/10.1055/s-0038-1675612.
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Objective To characterize the patterns of cell differentiation, proliferation, and tissue invasion in eutopic and ectopic endometrium of rabbits with induced endometriotic lesions via a well- known experimental model, 4 and 8 weeks after the endometrial implantation procedure. Methods Twenty-nine female New Zealand rabbits underwent laparotomy for endometriosis induction through the resection of one uterine horn, isolation of the endometrium, and fixation of tissue segment to the pelvic peritoneum. Two groups of animals (one with 14 animals, and the other with15) were sacrificed 4 and 8 weeks after endometriosis induction. The lesion was excised along with the opposite uterine horn for endometrial gland and stroma determination. Immunohistochemical reactions were performed in eutopic and ectopic endometrial tissues for analysis of the following markers: metalloprotease (MMP-9) and tissue inhibitor of metalloprotease (TIMP-2), which are involved in the invasive capacity of the endometrial tissue; and metallothionein (MT) and p63, which are involved in cell differentiation and proliferation. Results The intensity of the immunostaining for MMP9, TIMP-2, MT, and p63 was higher in ectopic endometria than in eutopic endometria. However, when the ectopic lesions were compared at 4 and 8 weeks, no significant difference was observed, with the exception of the marker p63, which was more evident after 8 weeks of evolution of the ectopic endometrial tissue. Conclusion Ectopic endometrial lesions seem to express greater power for cell differentiation and tissue invasion, compared with eutopic endometria, demonstrating a potentially invasive, progressive, and heterogeneous presentation of endometriosis.
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Tolibova, Gulrukhsor Kh, Tatyana G. Tral, and Igor Yu Kogan. "Morphological evaluation of the hypoplastic endometrium in women with ineffective art protocols." Journal of obstetrics and women's diseases 69, no. 5 (December 23, 2020): 39–48. http://dx.doi.org/10.17816/jowd69539-48.
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Hypothesis/aims of study. The hypoplastic endometrium has a significant negative impact on the probability of pregnancy and is one of the adverse factors influencing on the effectiveness of assisted reproductive technology (ART) protocols. Violation of the structural and functional characteristics of the endometrium associated with hypoplasia leads to endometrial dysfunction. In this regard, the relevance of a morphological study of the hypoplastic endometrium is beyond doubt. This study was aimed to determine the morphofunctional pattern of the hypoplastic endometrium in patients with a history of ineffective ART protocols.
Study design, materials and methods. Histological and immunohistochemical studies of the endometrium were performed in 340 patients. The endometrial receptor profile (estrogen receptors, ER; progesterone receptors, PR) and pro-inflammatory markers (CD8+, CD20+, CD4+, CD138+) were evaluated by immunohistochemical method.
Results. The morphological pattern of the hypoplastic endometrium in patients with ineffective ART protocols was characterized by polymorphic transformation variants with impaired endometrial receptor profile. This impaired proliferative and secretory transformation of the hypoplastic endometrium is underlain by damage to the endometrium basal layer resulted from intrauterine interventions and chronic endometritis with components of stromal fibrosis, sclerosis of the spiral arteries, and increased number of pro-inflammatory markers that led to endometrial dysfunction.
Conclusion. This article first describes the morphological variants of the hypoplastic endometrium in women with ineffective ART protocols. Integration of comprehensive morphological diagnostics with verification of the transformation variant of the hypoplastic endometrium can serve as the basis for rehabilitation therapy.
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Curcic, Aleksandar, Srdjan Djurdjevic, Slobodana Mihaldzic-Tubic, Ljiljana Mladenovic-Segedi, and Marko Maksimovic. "Ultrasound detection of endometrial fluid in postmenopausal women." Medical review 62, no. 7-8 (2009): 337–41. http://dx.doi.org/10.2298/mpns0908337c.
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Introduction. The aim of this prospective study was to estimate whether the presence of endometrial fluid detected by transvaginal ultrasound investigation was a marker for the pathological changes of the endometrium in postmenopausal women. Material and methods. 128 postmenopausal women with uterine bleeding and 29 asymptomatic postmenopausal women underwent transvaginal ultrasound investigation, curettage and histopathological investigation of the curettage specimens. Results. There were significantly more asymptomatic women with endometrial fluid collection was found (41,4%) than those with uterine bleeding (7,8%) (p<0,001). We found 4 cases of carcinoma of the endometrium, 4 with hyperplasia and 1 with polyp of the endometrium in women with uterine bleeding and endometrial fluid collection. In the asymptomatic group of women we found 1 case with polyp and 1 with carcinoma of the endometrium. In the presence of endometrial fluid collection the least thickness of the endometrium measured by transvaginal ultrasound was 12 mm in postmenopausal women with carcinoma of the endometrium, 7 mm in women with hyperplasia and 5 mm with polyp. No pathological changes were found below the above values. Conclusion. The presence of endometrial fluid detected by transvaginal ultrasonography is a good marker for pathological changes of the endometrium in postmenopausal women if the endometrial thickness is greater than 4 mm. If the endometrial thickness is 4 mm or less, the presence of endometrial fluid is not an indication for further invasive investigation of endometrial cavity, but we must eliminate possible presence of ednexal or cervical malignant disease in some patients.
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Gambhire-Bhadugale, Harsha, Tekawade UV, Suhas Herlekar, and Manasi Kulkarni. "Treating thin endometrium by Ayurvedic Medications: A Case Study." International Journal of Ayurvedic Medicine 13, no. 4 (January 7, 2023): 1102–7. http://dx.doi.org/10.47552/ijam.v13i4.3136.
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Infertility is one of the most prevalent chronic health disorders involving young adults. Infertility is defined as failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. Endometrium is one of the important factors for successful pregnancy. Endometrial thickness is a marker for endometrial receptivity and a prognostic factor for pregnancy. A thin endometrium is generally defined as endometrial thickness less than 7 mm. Thin endometrium adversely affect reproductive performance. A thin endometrium is generally defined as endometrial thickness less than 7 mm. This is a case report of a female patient with thin endometrium with a complaint of inability to conceive for 2 years of regular unprotected intercourse. The menstrual blood is the shedded functional layer of endometrium of the uterus. In Ayurveda, the term rajah is used for menstrual blood. So, this case is considered as Rajah-Kshay and is treated accordingly. The treatment plan includes Rasa & Rakta Pachak (Blood Purifiers) medications and Uttarbasti (Vaginal administration of liquid medicine) of Phalaghrita to increase Dharan kshamata (implantation) of endometrium. During the treatment period this patient’s endometrial thickness increased from 6.1 mm to 9 mm and menstrual flow increased. This led to her conception within 5 months of treatment and she delivered a healthy baby boy.
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Guo, Shiying, Hong Chen, Ying Xu, Doudou Ding, and Aihua Chen. "ATI-2341 TFA promotes repair of damaged endometrium by mediating the differentiation of bone marrow mesenchymal stem cells." Materials Express 14, no. 1 (January 1, 2024): 26–31. http://dx.doi.org/10.1166/mex.2024.2576.
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Intrauterine adhesion (IUA) is a common complication in endometrial disorder. This study investigated the role of ATI-2341, a functionally selective allosteric regulator of CXCR4 in IUAs, and its interaction with bone marrow-derived mesenchymal stem cells (BMSCs). Following establishment of endometrial injury model, rats BMSCs were treated with ATI-2341 TFA (100 ng/mL). Endometrial tissues of rats with IUA were treated with BMSCs and estrogen, or untreated which was taken as controls. The endometrium thickness was examined and endometrial BMSC proliferation was detected by MTT assay. Levels of MMP-9, TIMP-1, CK, and VIM were determined by Western blot analysis. Treatment with ATI-2341 TFA resulted in significantly decreased level of MMP-9 (0.346±0.036 ng/mL), compared with estrogen treatment (0.467±0.029 ng/mL) and control treatment. Both BMSCs carrying ATI-2341 TFA and estrogen induced increased expression of TIMP-1 (0.734±0.034 ng/mL, 0.618±0.035 ng/mL) and enhanced endometrim growth with thicker endometrium in ATI-2341 TFA group (294.21±59.97 μm). 48 h and 72 h after treatment, ATI-2341 TFA group and estrogen group exhibited increased proliferation rate (P <0.05), and higher rate appeared upon ATI-2341 TFA treatment. Cells in ATI-2341 TFA100 ng/mL and estrogen group were greatly positive for keratin and negative for vimentin. Collectively, ATI-2341 TFA promotes the differentiation of BMSCs into endometrial epithelial cells, enhances repair of damaged endometrium, and alleviate IUA. These findings might underlie a foundation for BMSC-based treatment for endometrial disorder.
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Mуkуtуn, Kseniia. "MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL CHANGES OF THE ENDOMETRIUM IN WOMEN WITH HYPERPROLIFERATIVE PATHOLOGY OF THE UTERUS AND REPRODUCTIVE DYSFUNCTION." Eastern Ukrainian Medical Journal 10, no. 3 (2022): 241–46. http://dx.doi.org/10.21272/eumj.2022;10(3):241-246.
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Hyperproliferative pathology of the uterus (HPЕ) occupies one of the leading places in the structure of female infertility, leading to women’s generative dysfunction in 80% of cases. The aim of the study: to assess the immunohistochemical and morphological features of the endometrium in patients with hyperproliferative pathology of the endometrium and infertility. Materials and methods. Forty endometrial samples from women with infertility and hyperproliferative pathology of the endometrium were examined: 20 samples of endometrium obtained from women with infertility and endometrial polyps (1 group) and 20 samples obtained from women with infertility and endometrial hyperplasia without atypia. The endometrium of 20 healthy women was examined as the control group. Pipelle biopsy of the endometrium was performed in the luteal phase of the menstrual cycle in women of the main and control groups to obtain the material. The morphological and immunohistochemical features of the endometrium in women with infertility and hyperproliferative pathology of the endometrium were determined. Histogram sections were stained with hematoxylin and eosin, and picrofuxin (Van Gizon’s stain). An immunohistochemical study was performed with the polymer detection method of antigen application using the UltraVisionQuanto peroxidase polymer and DAB plus chromogen detection system to determine the expression of monoclonal antibodies to estrogen and progesterone receptors, natural killers СD-56 and СD-138. The results of the investigation. Morphological examination of the endometrium of women with infertility and hyperproliferative pathology of the endometrium revealed a number of pathological changes: glandular and glandular-fibrous polyps of the endometrium (70–80%), atypical endometrial hyperplasia (10–20%), dyschronosis of endometrial receptivity (40–50%), morphological signs of chronic endometritis, positive expression of CD-138 (10%), as well as their combination. Conclusions. Women with infertility and hyperproliferative pathology of the uterus and unsuccessful attempts at ART have expressed dyshronosis of receptivity of the endometrium on the background of reduced expression of endometrial natural killers and positive expression of CD-138. It is indicative of the dysregulation of immunological homeostasis on the local level, which may be the cause of disruption of blastocyst implantation processes, unsuccessful attempts of ART and lead to early pregnancy loss.
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Sankareswari, R., and Ramya Sreevarshni Shunmugha Sundharam. "Histopathological features of endometrium in those with symptoms suggestive of female genital tuberculosis." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 5 (April 28, 2018): 1827. http://dx.doi.org/10.18203/2320-1770.ijrcog20181911.
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Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of female genital TB is not complete without tissue diagnosis. The aim of the present study was to find out the histopathological pattern of theendometrium in those with symptoms suggestive of genital tuberculosis.Methods: A random sample of 200 female OPD patients with symptoms suggestive of FGTB attending to the Obstetrics and Gynaecology OPD in a tertiary care hospital at Ariyur, Puducherry were subjected to endometrial curettage and histological characteristics of endometrial biopsy material was assessed.Results: Endometrial histopathology revealed proliferative endometrium (60.5%, n=121), secretary endometrium (25.5%, n=51) and menstrual endometrium (9%, n=18) in majority. Chronic endometritis (3%, n=6), Simple hyperplasia without atypia (1%, n=2), atrophic (0.5%, n=1) and inert endometrium (0.5%, n=1) were other abnormalities reported.Conclusions: Histopathological features of endometrium in those with suggestive symptoms of female genital TB are variable and non-specific.
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Godbole, G. B., D. N. Modi, and C. P. Puri. "Regulation of homeobox A10 expression in the primate endometrium by progesterone and embryonic stimuli." Reproduction 134, no. 3 (September 2007): 513–23. http://dx.doi.org/10.1530/rep-07-0234.
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Homeobox A10 (HOXA10), a member of abdominal B subclass of homeobox genes, is responsible for uterine homeosis during development. Intriguingly, in the adult murine uterus, HOXA10 has been demonstrated to play important roles in receptivity, embryo implantation, and decidualization. However, the roles of HOXA10 in the primate endometrium are not known. To gain insights into the roles of HOXA10 in the primate endometrium, its expression was studied in the endometria of bonnet monkey (Macaca radiata) in the receptive phase and also in the endometria of monkeys treated with antiprogestin onapristone (ZK98.299) or in conception cycle where the presence of preimplantation stage blastocyst was verified. In addition, the mRNA expression of HOXA11 and insulin-like growth factor-binding protein 1 (IGFBP1) was evaluated by real-time PCR in these animals.The results revealed that HOXA10 in the luteal phase primate endometrium is differentially expressed in the functionalis and the basalis zones, which is modulated in vivo by progesterone and also by the signals from the incoming embryo suggesting the involvement of HOXA10 in the process of establishment of pregnancy in primates. In addition, the results also demonstrated that the expression of IGFBP1 but not HOXA11 is coregulated with HOXA10 in the endometria of these animals. The pattern of changes in the expression of HOXA10 in response to the two stimuli suggests that endometrial receptivity and implantation not only requires a synchrony of maternal and embryonic signaling on endometrial cells in the primates but there also exists a controlled differential response among the cells of various uterine compartments.
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Löffelmann, Anna C., Alena Hoerscher, Muhammad A. Riaz, Felix Zeppernick, Ivo Meinhold-Heerlein, and Lutz Konrad. "Claudin-10 Expression Is Increased in Endometriosis and Adenomyosis and Mislocalized in Ectopic Endometriosis." Diagnostics 12, no. 11 (November 17, 2022): 2848. http://dx.doi.org/10.3390/diagnostics12112848.
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Claudins, as the major components of tight junctions, are crucial for epithelial cell-to-cell contacts. Recently, we showed that in endometriosis, the endometrial epithelial phenotype is highly conserved, with only minor alterations. For example, claudin-11 is strongly expressed; however, its localization in the endometriotic epithelial cells was impaired. In order to better understand the role of claudins in endometrial cell-to-cell contacts, we analyzed the tissue expression and localization of claudin-10 by immunohistochemistry analysis and two scoring systems. We used human tissue samples (n = 151) from the endometrium, endometriosis, and adenomyosis. We found a high abundance of claudin-10 in nearly all the endometrial (98%), endometriotic (98–99%), and adenomyotic (90–97%) glands, but no cycle-specific differences and no differences in the claudin-10 positive endometrial glands between cases with and without endometriosis. A significantly higher expression of claudin-10 was evident in the ectopic endometrium of deep-infiltrating (p < 0.01) and ovarian endometriosis (p < 0.001) and in adenomyosis in the cases with endometriosis (p ≤ 0.05). Interestingly, we observed a shift in claudin-10 from a predominant apical localization in the eutopic endometrium to a more pronounced basal/cytoplasmic localization in the ectopic endometria of all three endometriotic entities but not in adenomyosis. Significantly, despite the impaired endometriotic localization of claudin-10, the epithelial phenotype was retained. The significant differences in claudin-10 localization between the three endometriotic entities and adenomyosis, in conjunction with endometriosis, suggest that most of the aberrations occur after implantation and not before. The high similarity between the claudin-10 patterns in the eutopic endometrial and adenomyotic glands supports our recent conclusions that the endometrium is the main source of endometriosis and adenomyosis.
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Zhu, Xinxin, Bruno Péault, Guijun Yan, Haixiang Sun, Yali Hu, and Lijun Ding. "Stem Cells and Endometrial Regeneration: From Basic Research to Clinical Trial." Current Stem Cell Research & Therapy 14, no. 4 (May 23, 2019): 293–304. http://dx.doi.org/10.2174/1574888x14666181205120110.
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Monthly changes in the endometrial cycle indicate the presence of endometrial stem cells. In recent years, various stem cells that exist in the endometrium have been identified and characterized. Additionally, many studies have shown that Bone Marrow Mesenchymal Stem Cells (BM-MSCs) provide an alternative source for regenerating the endometrium and repairing endometrial injury. This review discusses the origin of endometrial stem cells, the characteristics and main biomarkers among five types of putative endometrial stem cells, applications of endometrium-derived stem cells and menstrual blood-derived stem cells, the association between BM-MSCs and endometrial stem cells, and progress in repairing endometrial injury.
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Di Paola, M., G. Loverro, A. M. Caringella, G. Cormio, and L. Selvaggi. "Receptorial and mitochondrial apoptotic pathways in normal and neoplastic human endometrium." International Journal of Gynecologic Cancer 15, no. 3 (2005): 523–28. http://dx.doi.org/10.1136/ijgc-00009577-200505000-00018.
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Under normal conditions, in human endometrium, apoptotic and antiapoptotic factors play an important role in tissue homeostasis. Abnormalities of apoptosis, a process implicated in several events in the reproductive organs, may contribute to neoplastic transformation. The present study aimed to investigate the involvement of both the receptorial and the mitochondrial pathways of apoptosis in normal endometrium and in endometrial carcinoma, by measuring caspase-3 and caspase-8 activities and cytosolic cytochrome c levels. Twelve endometrial carcinomas and nine normal endometrial specimens (four in mild proliferative phase, five in late secretory phase) were included in this study. Cytosolic fractions, obtained by differential centrifugation of tissue homogenates, were analyzed for caspase-3 and caspase-8 activities, as well as for cytochrome c content. Caspase-8 activity in normal secretory phase endometrium was higher than that in the proliferative phase and in the endometrial carcinoma. Moreover, higher cytochrome c levels were detected in endometrial carcinoma with respect to normal secretive endometrium. No significant differences were found in caspase-3 activity between normal and pathologic endometrium. The results obtained suggest that in normal endometrium, apoptosis takes place through the activation of both receptorial and mitochondrial pathways. Defects in both these pathways may contribute to the development of endometrial carcinoma.
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Coelho, Jyotsna Mirabel, Nagarathna G., and Dinesh Shet. "Study of tamoxifen associated endometrial changes in women with breast cancer: a prospective study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 12 (November 28, 2023): 3542–47. http://dx.doi.org/10.18203/2320-1770.ijrcog20233631.
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Background: Studies have estimated that women with breast cancer on tamoxifen therapy have a greater risk of developing endometrial cancer. We undertook this study to correlate the ultrasonographic findings, hysteroscopy findings and endometrial pathology in breast cancer patients on tamoxifen. Methods: This was a prospective study conducted over a period of two years. Patients of histologically proven breast cancer on tamoxifen treatment for more than a year were taken into the study. Transvaginal ultrasonography and hysteroscopic biopsy (if endometrial thickness on TVS was 8mm or more) was performed. SPSS software was used for statistical analysis of data. Results: 23 patients had an endometrial thickness between 5-10 mm. 23 between 10.1-15 mm, 13 between 15.1-20 mm and only 1 patient had an ET of more than 20 mm with a mean of 12.27 mm. On Hysteroscopy 24 patients (51%) had a bald endometrium, 14 (29.8%) had hyperplastic endometrium and 9 (19.2%) had polypoid endometrium. On endometrial biopsy, 19 patients had atrophic endometrium, 14 had polypoid endometrium, 11 had non secretory and 7 had secretory endometrium, 1 patient had disordered proliferative endometrium, 1 as hyperplasia without atypia and 1 with complex hyperplasia. 2 were reported as adenocarcinoma. Conclusions: Usage of tamoxifen is warranted in view of its benefits outweighing its risks, the need of a screening program for patients who receive tamoxifen for a prolonged period and the need for a hysteroscopic biopsy when the endometrial thickness is more than 8mm especially in the symptomatic patients.
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Putra, Very Great Eka, and Teuku Mirza Iskandar. "Endometrial thickness is a prognostic factor in endometrial carcinoma." Bali Medical Journal 12, no. 2 (July 4, 2023): 2083–87. http://dx.doi.org/10.15562/bmj.v12i2.4552.
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Background: Ultrasonography is a method that is commonly used today to measure endometrial thickness. It is useful as the initial step to detect endometrial hyperplasia or cancer in women with abnormal uterine bleeding. This study seeks to explore the predictive role of endometrial thickness in the development of endometrial cancer and identify the variables that affect endometrial thickness. Methods: This study is a cross sectional retrospective analytical study of women with a history of endometrial cancer who underwent transabdominal ultrasonography or transvaginal ultrasonography (TVS) followed by complete surgical staging between January 2019 and December 2021 at Dr. Kariadi General Hospital Semarang. Patients were categorized by endometrial thickness into ≤8 mm and >8 mm. In order to compare the endometrial thickness and clinicopathology traits, a bivariate analysis was done. The study proceeded with multivariate analysis and logistic regression if more than one bivariate analysis revealed a significant correlation (p<0.25). Results: This study involved 55 participants who had endometrial thickness measurements taken. Endometrial thickness was used to divide the patient population into two groups: ≤8 mm (n=28) and >8 mm (n=27). Tumor differentiation grading showed a significant difference between the two groups (p<0.001). The thickness of the endometrium is a significant prognostic of endometrial carcinoma based on the degree of tumor differentiation (p<0.001). With each millimeter increase in the endometrium, the likelihood of endometrial carcinoma increases significantly by 1,25 [p<0.001; 95%CI =1.112-1.404] times. Conclusion: As a result, the degree of tumor differentiation on post-operative histological analysis is correlated with the thickness of the endometrium. The endometrium's thickness considerably increased as the tumor differentiation level deteriorated. These findings highlight the significance of endometrial thickness as a possible predictor of tumor differentiation and prognosis in endometrial cancer.
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Bohiltea, Roxana Elena, Corina Grigoriu, Bianca-Margareta Mihai, Nicolae Bacalbasa, Irina Balescu, Mihai Mitran, Tiberiu Augustin Georgescu, et al. "Ten ultrasound endometrial issues." Romanian Medical Journal 68, S6 (December 30, 2021): 37–48. http://dx.doi.org/10.37897/rmj.2021.s6.7.
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Abnormal uterine bleeding is probably the most frequent gynecological issue that leads women to a consult with a subsequent ultrasound. Transvaginal ultrasonographic evaluation represents the most sensitive method of endometrial evaluation, being more adequate than the transabdominal approach, especially when differentiating the benign lesions from the malignant ones. Transvaginal ultrasound is extremely useful in measurement, morphology and vascularization examination of the uterine cavity, especially the endometrium. We present 10 endometrial issues in which transvaginal ultrasound has proven its utility in the paraclinical evaluation of the patient: endometrial cycle phase, endometrial thickness, endomyometrial junction, endometrial vacuum line, cystic endometrium, endometrial vascularization, endometrial polyp, intracavitary development of leiomyomas, thick endometrium and endometrial cancer.
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Wen, Xue, Yao Xiong, Huimin Liu, Ting Geng, Ling Jin, Ming Zhang, Ling Ma, and Yuanzhen Zhang. "Decreased mixed lineage leukemia 1 is involved in endometriosis-related infertility." Journal of Molecular Endocrinology 66, no. 1 (January 2021): 45–57. http://dx.doi.org/10.1530/jme-20-0193.
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The aberrant histone methylation patterns contribute to the pathogenesis of endometriosis (EM). Mixed lineage leukemia 1 (MLL1), a histone methyltransferase, is crucial for gene expression by catalyzing the trimethylation of histone 3 lysine 4 (H3K4me3) in gene promoter. This study aimed to explore whether MLL1 is involved in EM-related infertility. The expressions of MLL1 and H3K4me3 were analyzed in the eutopic endometria from EM women with infertility (n = 22) and the normal endometria from EM-free women (n = 22). Mouse EM model was established. The MLL1 and H3K4me3 expression patterns in mice endometria of early pregnancy were also investigated. Immortalized human endometrial stromal cells (iESCs) were cultured and underwent in vitro decidualization. The chromatin immunoprecipitation followed by deep sequencing (ChIP-seq) was performed to find the target gene of MLL1 during decidual process. Results showed that both MLL1 and H3K4me3 decreased in the eutopic endometrium from EM patients compared to that in the normal endometrium. During early pregnancy and the decidual process, MLL1 and H3K4me3 were significantly upregulated in stromal cells. ChIP-seq and ChIP-qPCR found that the cytochrome c oxidase subunit 4I 2 (COX4I2) was directly targeted by MLL1. The dominance of COX4I2-containing enzyme induced the expression of hypoxia-inducible factor-2α (HIF-2α), whose expression in the peri-implantation endometrium is essential for embryo implantation. Further results showed that MLL1 was directly regulated by progesterone (P4) – P4 receptors (PRs). Our study proved that MLL1 was involved in EM-related infertility, which may provide a novel approach to treat the nonreceptive endometrium in EM patients.
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Rebordão, Maria Rosa, Ana Amaral, Carina Fernandes, Elisabete Silva, Karolina Lukasik, Anna Szóstek-Mioduchowska, Pedro Pinto-Bravo, António Galvão, Dariusz J. Skarzynski, and Graça Ferreira-Dias. "Enzymes Present in Neutrophil Extracellular Traps May Stimulate the Fibrogenic PGF2α Pathway in the Mare Endometrium." Animals 11, no. 9 (September 6, 2021): 2615. http://dx.doi.org/10.3390/ani11092615.
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Endometrosis, a fibrotic disease of mare endometrium, impairs uterine function. Prostaglandins (PG), despite modulating reproductive physiological functions, may also cause local pathological collagen deposition (fibrogenesis). We have previously shown that neutrophil extracellular traps (NETs) may also favor mare endometrosis. The aim of this study was to investigate the effect of enzymes present in NETs on PGF2α-pathway activation. Kenney and Doig’s type I/IIA and IIB/III mare endometria, from follicular phase (FLP) and mid-luteal (MLP) phase, were cultured in vitro in the presence of NETs enzymes (elastase, cathepsin-G or myeloperoxidase). Production of PGF2α (EIA) and transcription (qPCR) of its synthases (PTGS2, AKR1C3) and receptor (PTGFR) genes were evaluated. PGF2α and PTGFR were influenced by endometrial category and estrous cycle phase. In FLP endometrium, NETs enzymes induced both high PGF2α production and/or PTGFR transcription. In MLP type I/IIA tissues, down-regulation of PTGFR transcripts occurred. However, in MLP type IIB/III endometrium, high levels of PTGFR transcripts were induced by NETs enzymes. As PGF2α-pathway activation facilitates fibrogenesis in other tissues, PGF2α may be involved in endometrosis pathogenesis. In the mare, the endocrine microenvironment of healthy and pathological endometrium might modulate the PGF2α pathway, as well as fibrosis outcome on endometrium challenged by NETs enzymes.
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M., Priya, C. R. Anuradha, and Vijayashree Raghavan. "A retrospective study on endometrial patterns in abnormal uterine bleeding." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 8 (July 27, 2022): 2194. http://dx.doi.org/10.18203/2320-1770.ijrcog20221936.
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Background: To determine the type of endometrial patterns of the different age categories of women who presented as a case of abnormal uterine bleeding.Methods: This is a retrospective study conducted on 105 patients who presented with abnormal uterine bleeding who underwent fractional curettage in our hospital. The data on their age, presenting complaints, and comorbidities of all the women were collected. The patterns of endometrial changes were studied and classified.Results: The most common histopathological findings were anovulatory shedding (34.3%) and irregular shedding (18.1%). The other findings include irregular ripening, papillary endocervicitis, endocervicitis, pill endometrium, atrophic endometrium, squamous metaplasia, and endometrial hyperplasia. The most common malignant change seen was endometrioid carcinoma which was seen in women over 40 years of age.Conclusions: Histopathological examination of the endometrium shows a clear-cut differentiation between physiological and malignancy changes in the endometrium. Hence, endometrial sampling is considered the golden tool for accurate analysis of the endometrium.
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Kitaya, Kotaro, Takeshi Nakayama, Tomoharu Okubo, Haruo Kuroboshi, Shinji Fushiki, and Hideo Honjo. "Expression of Macrophage Inflammatory Protein-1β in Human Endometrium: Its Role in Endometrial Recruitment of Natural Killer Cells." Journal of Clinical Endocrinology & Metabolism 88, no. 4 (April 1, 2003): 1809–14. http://dx.doi.org/10.1210/jc.2002-020980.
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Human endometrium is infiltrated by natural killer (NK) cells throughout the menstrual cycle. The number of endometrial NK cells is low in the proliferative phase, but acutely increases after ovulation, and reaches a peak in the late secretory phase, suggesting that endometrium recruits these leukocytes selectively from circulating peripheral blood. We investigated the expression of macrophage inflammatory protein (MIP)-1β, a potential chemoattractant for NK cells, in the endometrium. RT-PCR and ELISA revealed that MIP-1β is expressed in the endometrium throughout the menstrual cycle at both the message and protein levels. MIP-1β expression is stronger in the secretory phase endometrium than in the proliferative phase endometrium. Immunohistochemistry revealed that MIP-1β is localized in the surface epithelial cells, glandular epithelial cells, and perivascular stromal cells throughout the menstrual cycle. Stromal cells in a wider perivascular area became immunoreactive in the secretory phase. There was a strong correlation between the endometrial MIP-1β concentration and the number of endometrial NK cells. Progesterone significantly induced MIP-1β secretion from cultured endometrial stromal cells, whereas 17β-estradiol had a weak effect. These results suggest that endometrial MIP-1β may be involved in the recruitment of NK cells from circulating peripheral blood.
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Patil, V. S., G. Sachdeva, D. N. Modi, R. R. Katkam, D. D. Manjramkar, I. Hinduja, and C. P. Puri. "Rab coupling protein (RCP): a novel target of progesterone action in primate endometrium." Journal of Molecular Endocrinology 35, no. 2 (October 2005): 357–72. http://dx.doi.org/10.1677/jme.1.01807.
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Acquisition of functional receptivity by the endometrium is assumed to be effected by progesterone-dependent expression and repression of several genes during the implantation window in a menstrual cycle. In the present study, we employed differential display (DD) reverse transcription–polymerase chain reaction (RT–PCR) to identify progesterone-dependent gene/gene fragments that are differentially expressed during the peri-implantation phase in receptive and nonreceptive endometria, obtained from fertile and infertile bonnet monkeys respectively. Receptive endometria were obtained from regularly cycling (n=5) fertile female bonnet monkeys. Endometrial nonreceptivity was induced by treating bonnet monkeys with either 2.5 mg (n=5) or 5.0 mg (n=5) onapristone (ZK 98.299), an antiprogestin, on every third day for one cycle. Ovulation, levels of circulatory hormones (estradiol and progesterone) and menstrual cycle length did not change in treated animals; however, endometrial growth was retarded. DD2, one of the differentially expressed cDNA fragments, showed higher representation in nonreceptive endometria than in receptive endometria. The DD2 sequence was found to be homologous to the sequence of the carboxyl terminal region of Rab coupling protein (RCP), a recently discovered protein involved in intracellular vesicular trafficking. To confirm the identity of DD2 as RCP, RT–PCR studies were carried out with a forward primer deduced from the RCP sequence and a reverse primer from the DD2 sequence. The product (DDRCP) obtained, when sequenced, revealed 95% homology with the nucleotide number 1196–1757 of human RCP cDNA. Furthermore, the pattern of DDRCP expression at transcript level was found to be similar to that shown by DD2; that is, it was higher in nonreceptive endometrium. Northern analysis using labeled DD2 or DDRCP cDNA fragments identified two transcripts of 6.0 and 4.0 kb in human endometrium. In situ hybridization studies using digoxigenin-labeled DD2 revealed significantly higher (P < 0.05) localization of endometrial RCP transcripts in the proliferative phase than in the peri-implantation phase in control animals. The localization was also significantly (P < 0.01) higher in peri-implantation-phase endometria from antiprogestin-treated animals than in control animals. These antiprogestin-treated animals, however, did not demonstrate any concomitant increase in the levels of immunoreactive endometrial Rab4 and Rab11 during the peri-implantation phase. A similar pattern of cycle-dependent RCP expression was observed in human endometrial biopsies. Furthermore, significantly higher (P < 0.05) levels of RCP transcripts were detected during the peri-implantation phase in women with unexplained infertility (n=3) than in fertile women (n=3). This is the first report indicating the endometrial expression of RCP and its hormonal regulation.
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Maruyama, Tetsuo. "A Revised Stem Cell Theory for the Pathogenesis of Endometriosis." Journal of Personalized Medicine 12, no. 2 (February 4, 2022): 216. http://dx.doi.org/10.3390/jpm12020216.
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During the past decade, a stem cell-based hypothesis has emerged (among many others) to explain the pathogenesis of endometriosis. The initial hypothesis proposed that endometriosis arose from a single or a few specific cells with stem cell properties, including self-renewal and multi-lineage cell differentiation. The origins of the endometriosis-initiating stem cells were thought to be the bone marrow, uterine endometrium, and other tissues. Based on the implantation or metastatic theory in combination with the initial stem cell theory, one or a few multipotent stem/progenitor cells present in the eutopic endometrium or bone marrow translocate to ectopic sites via fallopian tubes during menstruation, vasculolymphatic routes, or through direct migration and invasion. Subsequently, they give rise to endometriotic lesions followed by differentiation into various cell components of endometriosis, including glandular and stromal cells. Recent somatic mutation analyses of deep infiltrating endometriosis, endometrioma, and eutopic normal endometrium using next-generation sequencing techniques have redefined the stem cell theory. It is now proposed that stem/progenitor cells of at least two different origins—epithelium and stroma—sequentially, differentially, but coordinately contribute to the genesis of endometriosis. The dual stem cell theory on how two (or more) stem/progenitor cells differentially and coordinately participate in the establishment of endometriotic lesions remains to be elucidated. Furthermore, the stem/progenitor cells involved in this theory also remain to be identified. Given that the origin of endometriosis is eutopic endometrium, the candidate cells for endometriotic epithelium-initiating cells are likely to be endometrial epithelial cells positive for either N-cadherin or SSEA-1 or both. The candidate cells for endometriotic stroma-initiating cells may be endometrial mesenchymal stem cells positive for SUSD2. Endometrial side population cells are also a possible candidate because they contain unipotent or multipotent cells capable of behaving as endometrial epithelial and stromal stem/progenitor cells.
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Johnson, N. P., S. Baidya, S. O. Jessup, A. Muthukaruppan, W. E. Hadden, M. L. Hull, S. Mehta, A. N. Shelling, C. G. Print, and L. W. Chamley. "The Lipiodol Uterine Bathing Effect to Improve Fertility May Include Uterine Natural Killer Cell Up-regulation in the Endometrium." Fertility & Reproduction 03, no. 01 (January 30, 2021): 10–13. http://dx.doi.org/10.1142/s2661318221500018.
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BACKGROUND: Lipiodol has a dramatic short term fertility enhancing effect for women with endometriosis. Microarray studies have shown transcriptomic regulation of molecular markers of endometrial inflammation, most notably a consistent down-regulation of endometrial osteopontin. We further explored the endometrial bathing effect of lipiodol on leukocyte expression in endometrium. METHODS: A cohort of four women, nested within a randomised trial of twelve women assessing the lipiodol uterine bathing effect, was studied as an ‘own control’ group, with their mid-luteal endometrium assessed before and after endometrial lipiodol exposure. Pipelle endometrial sampling allowed endometrial assessment by immunochemistry. Endometrial tissue samples were assessed by immunochemistry for total CD45+ leukocytes, CD68+ macrophages, CD3+ T-cells and CD56+ uterine natural killer cells. RESULTS: There was a statistically significant increase in the mean density of uterine natural killer cells in the endometrium of women post-lipiodol. No other significant differences were found in the mean densities of all leukocytes, macrophages or T cells in the endometrium of women post-lipiodol. CONCLUSIONS: These preliminary data further support the concept of a uterine bathing effect of lipiodol. Whether the increase in the mean density of uterine natural killer cells in the endometrium might contribute to an improvement in endometrial receptivity to embryo implantation merits further investigation.
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Kozdrowski, Roland, Marcin Nowak, and Kornelia Omyła. "Factors influencing the infiltration of eosinophils into the mare’s endometrium." Acta Veterinaria Brno 90, no. 1 (2021): 63–67. http://dx.doi.org/10.2754/avb202190010063.
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Factors and consequences related to infiltration of the endometrium by eosinophils in the mare are not fully understood. The aim of the study was to determine the frequency of eosinophilic infiltration into the endometrium in chronically infertile mares and to determine factors conducive to this type of changes. A total of 117 samples of endometrium were collected from infertile mares, 15 samples of endometrium were collected from maiden mares, and all were evaluated histologically. Eosinophilic infiltration of the endometrium was found in 59 mares; in 10 mares, eosinophiles were the predominant cells that had infiltrated the endometrium. The probability of eosinophilic infiltration of the endometrium increases with the age of the mare and with a higher score of endometrial degeneration. The simultaneous infiltration of the endometrium by polymorphonuclear cells and mononuclear cells, in mares being in oestrus, and in mares having fluid in the uterus, also increased the probability. In the group of young mares, eosinophilic infiltration of the endometrium was not detected. Eosinophilic infiltration of the endometrium increases in chronically infertile mares with age and with the presence of other abnormalities observed in the endometrium. We suspect that presence of eosinophils in endometrial tissue together with other abnormalities can be considered as reducing factor for future fertility, however, this hypothesis should be evaluated critically.
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Mosher, A. A., M. W. Tsoulis, J. Lim, C. Tan, S. K. Agarwal, N. A. Leyland, and W. G. Foster. "Melatonin activity and receptor expression in endometrial tissue and endometriosis." Human Reproduction 34, no. 7 (June 18, 2019): 1215–24. http://dx.doi.org/10.1093/humrep/dez082.
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AbstractSTUDY QUESTIONAre melatonin receptors (melatonin receptor 1A (MR1A) and melatonin receptor 1B (MR1B)) expressed in human endometrium and endometriotic tissue, and does melatonin affect endometrial cell proliferation?SUMMARY ANSWERMelatonin receptors are expressed in human eutopic endometrium, endometriomas and peritoneal lesions, although to different extents, and melatonin treatment attenuated estradiol-induced endometrial epithelial cell proliferation in culture.WHAT IS KNOWN ALREADYMelatonin decreased endometriotic lesion volume in a rat model of endometriosis. Melatonin treatment reduced pain scores in and analgesic use by women with endometriosis.STUDY DESIGN, SIZE, DURATIONBasic science study using human endometrial tissue and an endometrial epithelial cell line.PARTICIPANTS/MATERIALS, SETTING, METHODSMeasurement of melatonin receptor expression (mRNA and protein) in women with surgically confirmed endometriosis (endometrioma (n = 20) or peritoneal lesion (n = 11) alone) and women without surgical evidence of endometriosis (control, n = 15). Collection of endometrial and endometriotic tissue samples, gynecologic history and demographic information. Quantification of estradiol (1.0 nM) and melatonin (0.1 nM–1.0 μM) ± estradiol-induced endometrial epithelial cell proliferation in cultures of endometrial epithelial cells (CRL-1671) following 24 and 48 hours of culture.MAIN RESULTS AND THE ROLE OF CHANCEMR1A and MR1B were localized by immunohistochemistry in glandular epithelial cells of endometrial biopsies from women with and without endometriosis. Both receptors were expressed in eutopic and ectopic endometrial tissue. mRNA expression of MR1A and MR1B was significantly greater in peritoneal lesions than in either endometriomas or eutopic endometrium. However, protein expression of MR1A was decreased in peritoneal lesions compared to control eutopic endometrium, whereas MR1B expression did not differ between the groups. Melatonin (0.1 nM–1.0 μM) treatment inhibited estradiol (1.0 nM)-induced endometrial epithelial cell proliferation at 48 hours but not 24 hours of culture.LIMITATIONS, REASONS FOR CAUTIONBeneficial effects of melatonin seen in culture have yet to be comprehensively evaluated in women with endometriosis.WIDER IMPLICATIONS OF THE FINDINGSOur data suggest that melatonin may be useful as an adjunct to current endometriosis treatments.STUDY FUNDING/COMPETING INTEREST(S)This study was supported by the Canadian Institutes of Health Research (grant MOP142230 to W.G.F.). A.A.M. is supported by a resident research grant through the Physicians Services Incorporated Foundation. The authors have no conflicts of interest.
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Orazov, M. R., S. V. Volkova, M. B. Khamoshina, and M. A. Soyunov. "Pathogenetic mechanisms causing abnormal inflammation in the eutopic endometrium of women with endometriosisassociated infertility and methods of its management." Voprosy ginekologii, akušerstva i perinatologii 20, no. 1 (2021): 138–45. http://dx.doi.org/10.20953/1726-1678-2021-1-138-145.
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This review aims to explore existing literature surrounding the pathogenic mechanisms causing inflammation in the eutopic endometrium of women with endometriosis-associated infertility. We discuss morphological and functional changes in the eutopic endometrium in patients with endometriosis and infertility. We also cover endometrial receptivity defects and the vicious circle of endometrial inflammation in patients with external genital endometriosis associated with infertility. There is a description of treatment methods for estrogen-induced inflammation in the eutopic endometrium in women with endometriosis-associated infertility. Key words: endometriosis, infertility, endometrium, dienogest
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Horcajadas, José A., Pablo Mínguez, Joaquín Dopazo, Francisco J. Esteban, Francisco Domínguez, Linda C. Giudice, Antonio Pellicer, and Carlos Simón. "Controlled Ovarian Stimulation Induces a Functional Genomic Delay of the Endometrium with Potential Clinical Implications." Journal of Clinical Endocrinology & Metabolism 93, no. 11 (November 1, 2008): 4500–4510. http://dx.doi.org/10.1210/jc.2008-0588.
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Context: Controlled ovarian stimulation induces morphological, biochemical, and functional genomic modifications of the human endometrium during the window of implantation. Objective: Our objective was to compare the gene expression profile of the human endometrium in natural vs. controlled ovarian stimulation cycles throughout the early-mid secretory transition using microarray technology. Method: Microarray data from 49 endometrial biopsies obtained from LH+1 to LH+9 (n = 25) in natural cycles and from human chorionic gonadotropin (hCG) +1 to hCG+9 in controlled ovarian stimulation cycles (n = 24) were analyzed using different methods, such as clustering, profiling of biological processes, and selection of differentially expressed genes, as implemented in Gene Expression Pattern Analysis Suite and Babelomics programs. Results: Endometria from natural cycles followed different genomic patterns compared with controlled ovarian stimulation cycles in the transition from the pre-receptive (days LH/hCG+1 until LH/hCG+5) to the receptive phase (day LH+7/hCG+7). Specifically, we have demonstrated the existence of a 2-d delay in the activation/repression of two clusters composed by 218 and 133 genes, respectively, on day hCG+7 vs. LH+7. Many of these delayed genes belong to the class window of implantation genes affecting basic biological processes in the receptive endometrium. Conclusions: These results demonstrate that gene expression profiling of the endometrium is different between natural and controlled ovarian stimulation cycles in the receptive phase. Identification of these differentially regulated genes can be used to understand the different developmental profiles of receptive endometrium during controlled ovarian stimulation and to search for the best controlled ovarian stimulation treatment in terms of minimal endometrial impact.
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Song, Gwonhwa, Fuller W. Bazer, and Thomas E. Spencer. "Pregnancy and interferon tau regulate RSAD2 and IFIH1 expression in the ovine uterus." Reproduction 133, no. 1 (January 2007): 285–95. http://dx.doi.org/10.1530/rep-06-0092.
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Radical S-adenosyl methionine domain containing 2 (RSAD2) encodes a cytoplasmic antiviral protein induced by interferons (IFN). Interferon-induced with helicase C domain 1 (IFIH1) is a RNA helicase involved in innate immune defense against viruses, growth suppression, and apoptosis. Interferon tau (IFNT), a Type I IFN produced by the peri-implantation ruminant conceptus, acts on the uterine endometrium to signal pregnancy recognition and promote receptivity to implantation. Transcriptional profiling identifiedRSAD2andIFIH1as IFNT regulated genes in the ovine uterine endometrium. This study tested the hypothesis thatRSAD2andIFIH1were induced in the endometrium in a cell type-specific manner by IFNT from the conceptus during early pregnancy. EndometrialRSAD2andIFIH1mRNA increased between days 12 and 16 of pregnancy, but not of the estrous cycle. In pregnant ewes,RSAD2andIFIH1mRNAs increased in endometrial glands, and stroma and immune cells, but not in the luminal epithelium. Neither gene was expressed in the trophectoderm of day 18 or 20 conceptuses. Progesterone (P4) treatment of ovariectomized ewes did not induce expressionRSAD2orIFIH1mRNA in the endometrium; however, intrauterine injections of IFNT induced expression ofRSAD2andIFIH1mRNA in endometria of ewes treated with P4, as well as in ewes treated with P4 and the progesterone receptor antagonist, ZK 136,317. These results indicate that conceptus IFNT induces bothRSAD2andIFIH1in a P4-independent manner in the ovine uterine endometrium. These two IFNT-stimulated genes are proposed to have biological roles in the establishment of uterine receptivity to the conceptus during implantation through induction of an antiviral state and modulation of local immune cells in the endometrium.
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Aganezova, Natalia V., Sergey S. Aganezov, and Ksenia E. Gogichashvili. "Endometrial receptivity in women of reproductive age with "thin" and "absolutely thin" endometrium." Gynecology 24, no. 6 (January 20, 2023): 478–86. http://dx.doi.org/10.26442/20795696.2022.6.201804.
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Aim. To evaluate the expression of steroid receptors (estrogen [ER] and progesterone [PR]) in the endometrium during the implantation window in females with a history of fertility disorders in "thin" and "absolutely thin" endometrium versus healthy females.
Materials and methods. A prospective comparative study was conducted. The study group (n=42) included patients with "thin" endometrium (7 mm M-echo 5 mm at cycle days 1113 according to ultrasound); the comparison group (n=10) included females with "absolutely thin" (5 mm according to ultrasound in the pre-ovulatory days) endometrium (females in both groups had a history of infertility and miscarriage of unclear reasons in the anamnesis); the control group included 16 healthy fertile females. A Pipelle biopsy of the uterine mucosa was performed on day 68 after ovulation, and a peripheral blood sample was obtained to measure the concentration of sex steroids (estradiol [E2] and progesterone [P]). Endometrial samples were examined by histological and immunohistochemical methods (ER, PR expression).
Results. All study participants had an ovulatory cycle of P16.1 nmol/L (day 68 after ovulation) and normal estrogen levels (E2, pmol/L). E2/P was similar in all cohorts (p0.05 for all measures). ER and PR expression in the endometrium similar to those in healthy females was detected in 20% of patients in the study and comparison groups (M-echo = 4.83.1 mm): 21% (9/42) and 20% (2/10), respectively. ER and PR expression in the endometrial glands and ER expression in the endometrial stroma were significantly different (p0.05) from healthy females in 79% (41/52) of patients with "thin" endometrium and 80% (8/10) of patients with "absolutely thin" endometrium. No differences in the ER or PR expression in the endometrium in females with hypoplastic endometrium were found (p0.05).
Conclusion. The M-echo value does not accurately determine endometrial hormonal-receptor abnormalities: 20% of the study participants with hypoplastic endometrium had ER and PR expression comparable to those in healthy females. No differences were found in the expression of endometrial estrogen and progesterone receptors in females with "thin" and "absolutely thin" endometrium.
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Rusda, Muhammad, Andri Sipahutar, and Andrina Yunita Murni Rambe. "Application of International Endometrial Tumor Analysis in Abnormal Uterine Bleeding: A Case Report." Open Access Macedonian Journal of Medical Sciences 10, T7 (March 17, 2022): 7–11. http://dx.doi.org/10.3889/oamjms.2022.9236.
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BACKGROUND: Abnormal uterine bleeding (AUB) is one of the clinical symptoms found in malignant conditions where the incidence of newly diagnosed cancers reached 100,000 cases in Europe in 2012 with an incidence of around 14.7/100,000 women. The International Endometrial Tumor Analysis (IETA) group, formed in Chicago in 2008, published a consensus stating how to examine and measure the endometrium. CASE REPORT: Mrs. M, 49 years old, came to Gynecology Clinic of USU Hospital on February 22, 2021, at 13.00 WIB with the complaints of prolonged menstruation for 2 months with a volume of >10 times changing pads. Menstrual pain was found. Low back pain was found. A history of bleeding between menstrual cycles was found. On ultrasound examination, anteflexed uterus was found with size of 6.95 × 4.2 × 3.85 cm, thickness of the endometrium: 1.64 cm and concluded as AUB-M (thickening of the endometrium). Then, the patient is diagnosed with AUB-M (thickening of the endometrium) and is planned to undergo a diagnostic curettage. Anatomical pathology results showed a complex hyperplasia endometrium without atypia cells. Acute AUB is defined as bleeding profusely so that prompt treatment is needed to prevent blood loss. Ultrasound examination is performed to assess the size, shape of the uterus, the presence of fibroids, polyps, adenomyosis, and uterine anomalies such as uterine didelphys, sometimes polycystic ovaries are also found. Endometrial biopsy can detect more than 90% of cancers. The pathology of the endometrium can diagnose endometrial cancer or determine the likelihood of cancer. These investigative modalities can assist in the diagnosis of endometrial polyps, adenomyosis, leiomyomas, uterine anomalies, and endometrial thickening associated with hyperplasia and malignancy. Curettage is considered to relieve ongoing menorrhagia. According to the SOGC, administration of nonsteroidal anti-inflammatory drugs can inhibit cyclo-oxygenase and reduce levels of endometrial prostaglandins. DISCUSSION: Acute AUB is defined as bleeding profusely so that prompt treatment is needed to prevent blood loss. Ultrasound examination is performed to assess the size, shape of the uterus, the presence of fibroids, polyps, adenomyosis, and uterine anomalies such as uterine didelphys, sometimes polycystic ovaries are also found. Endometrial biopsy can detect more than 90% of cancers. The pathology of the endometrium can diagnose endometrial cancer or determine the likelihood of cancer. These investigative modalities can assist in the diagnosis of endometrial polyps, adenomyosis, leiomyomas, uterine anomalies, and endometrial thickening associated with hyperplasia and malignancy. Curettage is considered to relieve ongoing menorrhagia. According to the SOGC, administration of nonsteroidal anti-inflammatory drugs can inhibit cyclo-oxygenase and reduce levels of endometrial prostaglandins. CONCLUSION: According to IETA, the vascular pattern in the endometrium is reported to be associated with the presence or absence of a “dominant vessel” or other specific pattern. Endometrial thickness is the maximum measurement in the sagittal plane. The accompanying ultrasound provides the measurement of endometrial thickness in the absence of intracavity fluid; the endometrium should be measured where it appears thickest. If intracavity pathology is present, total thickness of endometrium including the lesion should be recorded. Anatomic pathology by curettage is required in women with abnormal bleeding; histological evaluation of the endometrium may identify infectious or neoplastic lesions such as endometrial hyperplasia or cancer.
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Shivappa, Prateek, Roma Isaacs, Kavita Mandrelle, and Sunita Goyal. "Glycopenic endometrium in infertility." International Journal of Research in Medical Sciences 10, no. 8 (July 27, 2022): 1663. http://dx.doi.org/10.18203/2320-6012.ijrms20221976.
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Background: Infertility is a global health problem affecting 8-10% couples worldwide. Endometrium is considered to be sensitive indicator of ovarian, pituitary and hypothalamic function. The endometrium, which fails to produce adequate amount of glycogen is termed as ‘glycopenic uteri’. Glycopenic endometrium is said to be unfavourable for early blastocyst implantation leading to infertility in spite of ovulation. Endometrial aspiration/biopsy can be histologically dated based on the Dallenbach-Hellweg criteria which forms an essential part of histopathological examination of endometrium for infertility work-up. The aim of the study was to study the correlation of glycogen content with endometrial histomorphology in infertility.Methods: Cross-sectional observational study in which one hundred twenty-two endometrial specimens sent as curetting/ biopsy were studied. The Glycogen content of endometrium was graded from + to ++++ as given by Arzac and Blanchet. Statistical analysis was done on SPSS version 26.0. The categorical variables were represented by count (percentage) and the continuous variables were represented by mean±SD. The Chi-square test was used to find the association of glycogen content with infertility, the various phases of the endometrium and age.Results: Glycopenic endometrium was seen in 36.9% cases of infertility. Out of which, glycopenic endometrium was much more prevalent in patients with secondary infertility (47%) as compared to patients with primary infertility (35.1%). Conclusions: Glycogen depletion in secretory phase results in inadequate preparation of endometrium at the time of implantation. Assessment of glycogen is considered to be an essential part of histopathological examination.
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Alpoim-Moreira, Joana, Carina Fernandes, Maria Rosa Rebordão, Ana Luísa Costa, Miguel Bliebernicht, Telmo Nunes, Anna Szóstek-Mioduchowska, Dariusz J. Skarzynski, and Graça Ferreira-Dias. "Collagen Type III as a Possible Blood Biomarker of Fibrosis in Equine Endometrium." Animals 12, no. 14 (July 21, 2022): 1854. http://dx.doi.org/10.3390/ani12141854.
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Collagen pathological deposition in equine endometrium (endometrosis) is responsible for infertility. Kenney and Doig’s endometrial biopsy histopathological classification is the gold standard method for endometrosis evaluation, whereby blood biomarkers identification would be less invasive and could provide additional information regarding endometrosis diagnosis and fertility prognosis. This study aimed to identify blood biomarkers for endometrosis diagnosis (42 mares were used in experiment 1), and fertility assessment (50 mares were used in experiment 2). Reproductive examination, endometrial biopsy histopathological classification (Kenney and Doig) and blood collection were performed. Endometrium and serum collagen type I (COL1) and type III (COL3), and hydroxyproline concentrations were measured (ELISA). Serum COL3 cut-off value of 60.9 ng/mL allowed healthy endometria (category I) differentiation from endometria with degenerative/fibrotic lesions (categories IIA, IIB or III) with 100% specificity and 75.9% sensitivity. This cut-off value enabled category I + IIA differentiation from IIB + III (76% specificity, 81% sensitivity), and category III differentiation from others (65% specificity, 92.3% sensitivity). COL1 and hydroxyproline were not valid as blood biomarkers. Serum COL3 cut-off value of 146 ng/mL differentiated fertile from infertile mares (82.4% specificity, 55.6% sensitivity), and was not correlated with mares’ age. Only COL3 may prove useful as a diagnostic aid in mares with endometrial fibrosis and as a fertility indicator.
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Kumari, Khusboo, Manoj Kumar Paswan, Meghraj Kundan, and Shivlok N. Ambedkar. "A prospective study of endometrial histopathology in post-menopausal women in Jharkhand." Journal of Family Medicine and Primary Care 13, no. 5 (May 2024): 1696–700. http://dx.doi.org/10.4103/jfmpc.jfmpc_1331_23.
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ABSTRACT Introduction: Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal women. In the early menopausal years, endometrial hyperplasia, polyps and submucosal fibroids are common etiologies of post menopausal bleeding. The most common cause of postmenopausal bleeding is endometrial atrophy, comprises of 60-80%, while endometrial hyperplasia and endometrial cancer contribute to only 11% of Post menopausal bleeding. The aim of study is to analyses histomorphological pattern of endometrium in patients presenting with post-menopausal bleeding in Jharkhand. Materials and Methods: 103 postmenopausal women presenting to tertiary center of Jharkhand in 2020-22 with bleeding were subjected to endometrial curettage for histopathology. Analysis is based on morphological criteria to assess endometrium. Endometrial histology is of four categories: Proliferative, Secretory, premalignant and carcinoma. Results: The highest incidence of postmenopausal bleeding was noticed in age group of < 60 years and incidence of malignancy was higher after 57 years of age. The majority of patients had parity between 1 and 3 (78.6%). Malignant & premalignant lesions comprises about 22.3% among that 77.7% were due to benign causes. Among the benign causes of postmenopausal bleeding, proliferative endometrium was the commonest finding. Types of hyperplasia encountered were simple hyperplasia without atypia (6.8%), Complex hyperplasia without atypia (3.9%),Complex hyperplasia with atypia (4.8%) and Simple hyperplasia with atypia (4.8%). 21.4% of cases of postmenopausal bleeding were associated with atrophic endometrium. Secretory endometrium seen in 17.5% of women. Endometrial carcinoma accounted for 12.6% of cases of postmenopausal bleeding. Out of these 69.2% were of endometroid type of endometrial carcinoma, 15.3% were of papillary serous carcinoma and 15.3% had clear cell carcinoma. The mean age of patients with endometrium carcinoma was 62.3 years. All cases of endometrial carcinoma were associated with 1 or more risk factor like diabetes/hypertension/Nulligravida. Conclusion: Proliferative Endometrium was a major cause of postmenopausal bleeding. Among the malignant causes, endometrial adenocarcinoma of endometroid type was most frequent with a lower mean age at presentation than other high grade cancers like papillary serous carcinoma & clear cell carcinoma.
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Balathil, Ranjana, Heera Trivikrama Shenoy, Neena Mampilly, Rejeesh Saroja Ravi, Rabiyabi Vethavayal, and Lisha Lakshman. "Sonographic and histopathological findings endometrium among perimenopausal women with abnormal uterine bleeding- A cross sectional study in north Kerala." Indian Journal of Obstetrics and Gynecology Research 11, no. 2 (May 15, 2024): 294–300. http://dx.doi.org/10.18231/j.ijogr.2024.056.
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: AUB makes a perimenopausal woman to seek medical care. This study evaluated and correlated the endometrial thickness obtained by ultrasonography and histopathological findings of endometrium in perimenopausal women with AUB.A hospital based observational cross-sectional study was conducted in Obstetrics and Gynaecology Department, Baby Memorial Hospital, Calicut for a period of 18 months. Histo-pathologic evaluation of endometrial tissue was done and was correlated with endometrial thickness.: The average age of women enrolled was 47.88 years with standard deviation of 3.729. The average endometrial thickness was 12.40mm. Endometrial hyperplasia without atypia was the leading histopathological finding obtained after analysis of endometrium (21.5%). This study shows that there is a significant relationship between histopathology findings of endometrium and age of participant and between endometrial thickness and menorrhagia. There was no relationship between histopathology findings and endometrial thickness. Perimenopausal AUB should be evaluated in a systematic manner, so that endometrial hyperplasia, carcinoma endometrium could be diagnosed in a very early stage and prompt treatment be given at right time reducing morbidity improving the quality of life.
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Banu, S. K., J. Lee, M. C. Satterfield, T. E. Spencer, F. W. Bazer, and J. A. Arosh. "Molecular Cloning and Characterization of Prostaglandin (PG) Transporter in Ovine Endometrium: Role for Multiple Cell Signaling Pathways in Transport of PGF2α." Endocrinology 149, no. 1 (September 27, 2007): 219–31. http://dx.doi.org/10.1210/en.2007-1087.
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In ruminants, endometrial prostaglandin F2α (PGF2α) is the luteolytic hormone. Cellular transport of PGF2α in the uterine endometrium is critical for regulation of the estrous cycle. Molecular mechanisms responsible for control of PGF2α transport in endometrium during luteolysis are largely unknown. In the present study, we characterized the prostaglandin transporter (PGT) in ovine endometrium. Ovine PGT cDNA consists of 1935 nucleotides that encode 644 amino acids. In ovine endometria, PGT is highly expressed during the period of luteolysis, between d 14 and 16 of the estrous cycle, in luminal and glandular epithelia. Pharmacological and genomic inhibition of PGT indicates that it is responsible for influx and efflux of PGF2α in ovine endometrial epithelial cells. Inhibition of PGT during the period of luteolysis prevents the release of oxytocin-induced PGF2α pulses, and maintains functional corpus luteum and its secretion of progesterone. In ovine endometrial epithelial cells, protein kinase A and protein kinase C pathways are involved in regulating the influx of PGF2α, whereas epidermal growth factor receptor pathways are implicated in regulation of influx and efflux of PGF2α. The ERK1/2 pathway is associated with efflux of PGF2α, whereas Jun-amino-terminal kinase/stress-activated protein kinase pathways are involved in both efflux and influx of PGF2α. Phosphatidylinositol 3-kinase pathways are not involved in either influx or efflux of PGF2α in ovine endometrial epithelial cells. These are the first results to demonstrate a functional role for PGT in regulation of PGF2α efflux and influx in ovine endometrial cells that influence luteolytic mechanisms in ruminants.