Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression
Endometriosis (E) and adenomyosis (A) are associated with a wide spectrum of symptoms and may present various histopathological transformations, such as the presence of hyperplasia, atypia, and malignant transformation occurring under the influence of local inflammatory, vascular and hormonal factor...
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MDPI AG
2024-02-01
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| author | Anca-Maria Istrate-Ofiţeru Carmen Aurelia Mogoantă George-Lucian Zorilă Gabriela-Camelia Roşu Roxana Cristina Drăguşin Elena-Iuliana-Anamaria Berbecaru Marian Valentin Zorilă Cristina Maria Comănescu Stelian-Ștefăniță Mogoantă Constantin-Cristian Vaduva Elvira Brătilă Dominic Gabriel Iliescu |
| author_facet | Anca-Maria Istrate-Ofiţeru Carmen Aurelia Mogoantă George-Lucian Zorilă Gabriela-Camelia Roşu Roxana Cristina Drăguşin Elena-Iuliana-Anamaria Berbecaru Marian Valentin Zorilă Cristina Maria Comănescu Stelian-Ștefăniță Mogoantă Constantin-Cristian Vaduva Elvira Brătilă Dominic Gabriel Iliescu |
| author_sort | Anca-Maria Istrate-Ofiţeru |
| collection | DOAJ |
| description | Endometriosis (E) and adenomyosis (A) are associated with a wide spectrum of symptoms and may present various histopathological transformations, such as the presence of hyperplasia, atypia, and malignant transformation occurring under the influence of local inflammatory, vascular and hormonal factors and by the alteration of tumor suppressor proteins and the inhibition of cell apoptosis, with an increased degree of lesion proliferation. Material and methods: This retrospective study included 243 patients from whom tissue with E/A or normal control uterine tissue was harvested and stained by histochemical and classical immunohistochemical staining. We assessed the symptomatology of the patients, the structure of the ectopic epithelium and the presence of neovascularization, hormone receptors, inflammatory cells and oncoproteins involved in lesion development. Atypical areas were analyzed using multiple immunolabeling techniques. Results: The cytokeratin (CK) CK7+/CK20− expression profile was present in E foci and differentiated them from digestive metastases. The neovascularization marker cluster of differentiation (CD) 34+ was increased, especially in areas with malignant transformation of E or A foci. T:CD3+ lymphocytes, B:CD20+ lymphocytes, CD68+ macrophages and tryptase+ mast cells were abundant, especially in cases associated with malignant transformation, being markers of the proinflammatory microenvironment. In addition, we found a significantly increased cell division index (Ki67+), with transformation and inactivation of tumor suppressor genes p53, B-cell lymphoma 2 (BCL-2) and Phosphatase and tensin homolog (PTEN) in areas with E/A-transformed malignancy. Conclusions: Proinflammatory/vascular/hormonal changes trigger E/A progression and the onset of cellular atypia and malignant transformation, exacerbating symptoms, especially local pain and vaginal bleeding. These triggers may represent future therapeutic targets. |
| first_indexed | 2024-03-08T03:54:32Z |
| format | Article |
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| language | English |
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| series | International Journal of Molecular Sciences |
| spelling | doaj.art-4b3728ce41c14c4fb73b09d9b5d393e12024-02-09T15:14:37ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672024-02-01253178910.3390/ijms25031789Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its ProgressionAnca-Maria Istrate-Ofiţeru0Carmen Aurelia Mogoantă1George-Lucian Zorilă2Gabriela-Camelia Roşu3Roxana Cristina Drăguşin4Elena-Iuliana-Anamaria Berbecaru5Marian Valentin Zorilă6Cristina Maria Comănescu7Stelian-Ștefăniță Mogoantă8Constantin-Cristian Vaduva9Elvira Brătilă10Dominic Gabriel Iliescu11Department of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaENT Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, University Emergency County Hospital, 200642 Craiova, RomaniaDepartment of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, University Emergency County Hospital, 200642 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Forensic Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Anatomy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaGeneral Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, University Emergency County Hospital, 200642 Craiova, RomaniaEndometriosis (E) and adenomyosis (A) are associated with a wide spectrum of symptoms and may present various histopathological transformations, such as the presence of hyperplasia, atypia, and malignant transformation occurring under the influence of local inflammatory, vascular and hormonal factors and by the alteration of tumor suppressor proteins and the inhibition of cell apoptosis, with an increased degree of lesion proliferation. Material and methods: This retrospective study included 243 patients from whom tissue with E/A or normal control uterine tissue was harvested and stained by histochemical and classical immunohistochemical staining. We assessed the symptomatology of the patients, the structure of the ectopic epithelium and the presence of neovascularization, hormone receptors, inflammatory cells and oncoproteins involved in lesion development. Atypical areas were analyzed using multiple immunolabeling techniques. Results: The cytokeratin (CK) CK7+/CK20− expression profile was present in E foci and differentiated them from digestive metastases. The neovascularization marker cluster of differentiation (CD) 34+ was increased, especially in areas with malignant transformation of E or A foci. T:CD3+ lymphocytes, B:CD20+ lymphocytes, CD68+ macrophages and tryptase+ mast cells were abundant, especially in cases associated with malignant transformation, being markers of the proinflammatory microenvironment. In addition, we found a significantly increased cell division index (Ki67+), with transformation and inactivation of tumor suppressor genes p53, B-cell lymphoma 2 (BCL-2) and Phosphatase and tensin homolog (PTEN) in areas with E/A-transformed malignancy. Conclusions: Proinflammatory/vascular/hormonal changes trigger E/A progression and the onset of cellular atypia and malignant transformation, exacerbating symptoms, especially local pain and vaginal bleeding. These triggers may represent future therapeutic targets.https://www.mdpi.com/1422-0067/25/3/1789endometriosisadenomyosismultiple immunohistochemistry |
| spellingShingle | Anca-Maria Istrate-Ofiţeru Carmen Aurelia Mogoantă George-Lucian Zorilă Gabriela-Camelia Roşu Roxana Cristina Drăguşin Elena-Iuliana-Anamaria Berbecaru Marian Valentin Zorilă Cristina Maria Comănescu Stelian-Ștefăniță Mogoantă Constantin-Cristian Vaduva Elvira Brătilă Dominic Gabriel Iliescu Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression International Journal of Molecular Sciences endometriosis adenomyosis multiple immunohistochemistry |
| title | Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression |
| title_full | Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression |
| title_fullStr | Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression |
| title_full_unstemmed | Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression |
| title_short | Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression |
| title_sort | clinical characteristics and local histopathological modulators of endometriosis and its progression |
| topic | endometriosis adenomyosis multiple immunohistochemistry |
| url | https://www.mdpi.com/1422-0067/25/3/1789 |
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