Endometrial biopsy and density of nerve fibers in eutopic endometrium. Looking for easier ways to diagnose endometriosis

Abstract

The purpose of study was to evaluate if there is any difference between nerve fibers density in eutopic endometrium in women with and without endometriosis. The prospective case – control study conducted between October 2013 and December 2015. The study included 60 reproductive age women undergoing laparoscopy for suspected endometriosis, pelvic pain, or infertility and not currently receiving hormonal treatment for at least 3 months prior to laparoscopy. Immunohistochemical nerve fiber detection in endometrial curetting using anti-gene product 9.5 was compared with surgical diagnosis. The nerve fibers were detected in eutopic endometrium in women with and without endometriosis. PGP9.5 positive nerve fibers were found in 26 (43%) cases: 16 (50%) in women with endometriosis and 10 (36%) in women without endometriosis. The mean nerve fiber density was higher in the group with endometriosis (0.53 per mm² ± 0.68) than without endometriosis (0.48 per mm² ± 0.89), but no statistically significant difference was observed (p > .05). Test specificity was 64.3%, sensitivity 50%, positive predictive value – 61.5%, negative predictive value – 52.9%, and overall accuracy 56.7%. The detection of PGP9.5 positive nerve fibers in eutopic endometrium cannot be used as a reliable diagnostic test of diagnosing endometriosis.

摘要

本研究的目的是为了评估有无子宫内膜异位症的妇女在位子宫内膜神经纤维密度之间是否存在差异。这是于2013年10月至2015年12月进行的一项前瞻性病例-对照研究。该研究包括60名育龄期女性, 她们因可疑子宫内膜异位症、盆腔疼痛或不孕而接受腹腔镜检查, 在腹腔镜检查前至少3个月没有接受激素治疗。使用抗基因产物9.5对刮出的子宫内膜进行神经纤维免疫组化检测, 并与手术诊断进行比较。在有和没有子宫内膜异位症的女性中, 在位子宫内膜中检测都到神经纤维。在26（43％）例中发现了PGP9.5阳性的神经纤维：有子宫内膜异位症的女性为16（50％）例, 而无子宫内膜异位症的女性为10（36％）例。有子宫内膜异位症组的平均神经纤维密度（0.53 / mm²±0.68）高于无子宫内膜异位症组的平均神经纤维密度（0.48 / mm²±0.89）, 但无统计学差异（p> .05）。测试特异性为64.3％, 敏感性为50％, 阳性预测值为– 61.5％, 阴性预测值为– 52.9％, 总体准确度为56.7％。在位子宫内膜中PGP9.5阳性的神经纤维的检测不能作为子宫内膜异位症的可靠诊断方法。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Density of nerve fibers
• endometrial biopsy
• endometriosis

Disclosure statement

No potential conflict of interest was reported by the authors.