The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-Analysis
Chronic endometritis (CE) is the persistent inflammation of the endometrial lining associated with infertility and various forms of reproductive failures. The diagnosis of CE is based on the histological evidence of stromal plasma cells; however, standardized methods to assess plasma cells are still...
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MDPI AG
2023-06-01
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| Շարք: | Biomedicines |
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| Առցանց հասանելիություն: | https://www.mdpi.com/2227-9059/11/6/1714 |
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| author | Angela Santoro Antonio Travaglino Frediano Inzani Giuseppe Angelico Antonio Raffone Giuseppe Maria Maruotti Patrizia Straccia Damiano Arciuolo Federica Castri Nicoletta D’Alessandris Giulia Scaglione Michele Valente Federica Cianfrini Valeria Masciullo Gian Franco Zannoni |
| author_facet | Angela Santoro Antonio Travaglino Frediano Inzani Giuseppe Angelico Antonio Raffone Giuseppe Maria Maruotti Patrizia Straccia Damiano Arciuolo Federica Castri Nicoletta D’Alessandris Giulia Scaglione Michele Valente Federica Cianfrini Valeria Masciullo Gian Franco Zannoni |
| author_sort | Angela Santoro |
| collection | DOAJ |
| description | Chronic endometritis (CE) is the persistent inflammation of the endometrial lining associated with infertility and various forms of reproductive failures. The diagnosis of CE is based on the histological evidence of stromal plasma cells; however, standardized methods to assess plasma cells are still lacking. In the present paper, we aimed to determine the most appropriate plasma cell threshold to diagnose CE based on pregnancy outcomes. Three electronic databases were searched from their inception to February 2022 for all studies comparing pregnancy outcomes between patients with CE and patients without CE. The relative risk (RR) of pregnancy, miscarriage, and/or live birth rates were calculated and pooled based on the plasma cell threshold adopted. A <i>p</i>-value < 0.05 was considered significant. Nine studies adopting different thresholds (1 to 50 plasma cells/10 HPF) were included. In the meta-analysis, we only found a significant association between miscarriage rate and a plasma cell count ≥ 5/10 HPF (RR = 2.4; <i>p</i> = 0.007). Among studies not suitable for meta-analysis, CE showed an association with worsened pregnancy only when high thresholds (10 and 50/10 HPF) were adopted. In conclusion, our study suggests that the presence of plasma cells at low levels (<5/10 HPF) may not predict worsened pregnancy outcomes. Based on these findings, a threshold of ≥5 plasma cells/10 HPF may be more appropriate to diagnose CE. |
| first_indexed | 2024-03-11T02:43:27Z |
| format | Article |
| id | doaj.art-1f283ec4e56943ee8bf9af7b51a7d839 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T02:43:27Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-1f283ec4e56943ee8bf9af7b51a7d8392023-11-18T09:27:10ZengMDPI AGBiomedicines2227-90592023-06-01116171410.3390/biomedicines11061714The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-AnalysisAngela Santoro0Antonio Travaglino1Frediano Inzani2Giuseppe Angelico3Antonio Raffone4Giuseppe Maria Maruotti5Patrizia Straccia6Damiano Arciuolo7Federica Castri8Nicoletta D’Alessandris9Giulia Scaglione10Michele Valente11Federica Cianfrini12Valeria Masciullo13Gian Franco Zannoni14Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyAnatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Anatomic Pathology, University of Catania, 95123 Catania, ItalyGynecology and Obstetrics Unit, Department of Public Health, University of Naples Federico II, 80138 Naples, ItalyGynecology and Obstetrics Unit, Department of Public Health, University of Naples Federico II, 80138 Naples, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyDivision of Gynecologic Surgery, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, ItalyUnità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyChronic endometritis (CE) is the persistent inflammation of the endometrial lining associated with infertility and various forms of reproductive failures. The diagnosis of CE is based on the histological evidence of stromal plasma cells; however, standardized methods to assess plasma cells are still lacking. In the present paper, we aimed to determine the most appropriate plasma cell threshold to diagnose CE based on pregnancy outcomes. Three electronic databases were searched from their inception to February 2022 for all studies comparing pregnancy outcomes between patients with CE and patients without CE. The relative risk (RR) of pregnancy, miscarriage, and/or live birth rates were calculated and pooled based on the plasma cell threshold adopted. A <i>p</i>-value < 0.05 was considered significant. Nine studies adopting different thresholds (1 to 50 plasma cells/10 HPF) were included. In the meta-analysis, we only found a significant association between miscarriage rate and a plasma cell count ≥ 5/10 HPF (RR = 2.4; <i>p</i> = 0.007). Among studies not suitable for meta-analysis, CE showed an association with worsened pregnancy only when high thresholds (10 and 50/10 HPF) were adopted. In conclusion, our study suggests that the presence of plasma cells at low levels (<5/10 HPF) may not predict worsened pregnancy outcomes. Based on these findings, a threshold of ≥5 plasma cells/10 HPF may be more appropriate to diagnose CE.https://www.mdpi.com/2227-9059/11/6/1714chronic endometritisinfertilityhysteroscopyendometrial biopsypregnancy |
| spellingShingle | Angela Santoro Antonio Travaglino Frediano Inzani Giuseppe Angelico Antonio Raffone Giuseppe Maria Maruotti Patrizia Straccia Damiano Arciuolo Federica Castri Nicoletta D’Alessandris Giulia Scaglione Michele Valente Federica Cianfrini Valeria Masciullo Gian Franco Zannoni The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-Analysis Biomedicines chronic endometritis infertility hysteroscopy endometrial biopsy pregnancy |
| title | The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-Analysis |
| title_full | The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-Analysis |
| title_fullStr | The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-Analysis |
| title_short | The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta-Analysis |
| title_sort | role of plasma cells as a marker of chronic endometritis a systematic review and meta analysis |
| topic | chronic endometritis infertility hysteroscopy endometrial biopsy pregnancy |
| url | https://www.mdpi.com/2227-9059/11/6/1714 |
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