1
|
Huang J, You X, Zhao Z, Jiang X, Qu D. Chronic endometritis multiplies the recurrence risk of endometrial polyps after transcervical resection of endometrial polyps: a prospective study. BMC Womens Health 2024; 24:372. [PMID: 38918774 PMCID: PMC11201338 DOI: 10.1186/s12905-024-03221-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/21/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND To investigate the impact of chronic endometritis (CE) on the recurrence of endometrial polyps (EPs) in premenopausal women after transcervical resection of endometrial polyps (TCRP). METHODS This prospective study enrolled 507 women who underwent TCRP between January 1, 2022 and December 31, 2022. The patients were divided into a CE group (n = 133) and non-CE group (n = 374) based on the expression of CD138 in the endometrium. The EP recurrence rate at 1 year after TCRP was compared between the CE and non-CE groups and between groups with mild CE and severe CE. The impact of CD138 expression by resected EPs on EP recurrence also was investigated. RESULTS The EP recurrence rate at 1 year post-TCRP was higher in the CE group than in the non-CE group (25.6% vs. 10.4%) and also higher in the severe CE group than in the mild CE group (34.5% vs. 18.7%). Additionally, the EP recurrence rate was higher among patients with CD138-expressing EPs than among those with EPs lacking CD138 expression (30.5% vs. 6.5%). The odds ratio (OR) for EP recurrence in the CE cohort compared with the non-CE cohort was 3.10 (95% confidence interval [CI] 1.84-5.23) after adjustment for EP number and precautions against EP recurrence. The ORs for EP recurrence in patients with mild CE and severe CE were 2.21 (95%CI 1.11-4.40) and 4.32 (95%CI 2.26-8.26), respectively. Similarly, the OR for EP recurrence in cases with CD138-expressing EPs relative to cases with EPs lacking CD138 expression was 6.22 (95%CI 3.59-10.80) after adjustment for EP number and precautions against EP recurrence. CONCLUSIONS CE multiplied the recurrence rate of EPs in premenopausal women after TCRP, and this effect positively correlated with CE severity. CD138 expression by EPs also was associated with a higher risk for EP recurrence.
Collapse
Affiliation(s)
- Jing Huang
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, No 63, Wenhua Road, Nanchong, 637000, China
- Non-invasive and Micro-invasive Laboratory of Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Xiao You
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, No 63, Wenhua Road, Nanchong, 637000, China
- Non-invasive and Micro-invasive Laboratory of Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Zijun Zhao
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, No 63, Wenhua Road, Nanchong, 637000, China
- Non-invasive and Micro-invasive Laboratory of Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Xiaorui Jiang
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, No 63, Wenhua Road, Nanchong, 637000, China
- Non-invasive and Micro-invasive Laboratory of Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Dacheng Qu
- Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, No 63, Wenhua Road, Nanchong, 637000, China.
- Non-invasive and Micro-invasive Laboratory of Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
| |
Collapse
|
2
|
Wu X, Niu S, Zhao T. Establishment and verification of hysteroscopic scoring system for chronic endometritis in infertile patients. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:46-53. [PMID: 37283117 PMCID: PMC10407986 DOI: 10.3724/zdxbyxb-2022-0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/27/2022] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To establish and verify a hysteroscopic scoring system for the diagnosis of chronic endometritis (CE) in infertile patients. METHODS A total of 238 infertile patients who underwent hysteroscopy and endometrial biopsy in the Reproductive Medicine Center, Shijiazhuang Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University from October 1 to December 31, 2019 were enrolled in the study. According to the results of CD138 immunohistochemistry, the patients were divided into CE group (n=73) and non-CE group (n=165). Univariate and binary logistic regression analyses were used to screen the risk factors of CE and a nomogram was establish for hysteroscopic scoring. Receiver operating characteristic (ROC) curve, calibration curve and Bootstrap resampling method were used to evaluate and verify the system. RESULTS Univariate and binary logistic regression analyses showed that hyperemia area (HA) degree ≥2, micropolyps, polypoid hyperplasia of endometrium and history of ectopic pregnancy were independent risk factors for CE (all P<0.05). A nomogram was generated to establish a hysteroscopy scoring system based on the above four factors. The area under ROC curve of the hysteroscopy scoring system for predicting CE was 0.801 (95%CI:0.742-0.861), the sensitivity was 74.0% and the specificity was 73.9%. The calibration curve showed that the predicting value of the scoring system was highly consistent with the actual value. In the internal verification, the C-index was 0.7811. The predicting value of the verification group in the calibration curve was basically consistent with the actual value, indicating that the scoring system had good stability. CONCLUSIONS The hysteroscopic scoring system composed of HA, micropolyp, polypoid hyperplasia of endometrium and history of ectopic pregnancy can effectively and intuitively predict CE, which is conducive to improving the diagnosis of CE.
Collapse
Affiliation(s)
- Xiaohua Wu
- Reproductive Medicine Center, Shijiazhuang Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University, Shijiazhuang 050035, China.
| | - Shufang Niu
- Reproductive Medicine Center, Shijiazhuang Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University, Shijiazhuang 050035, China
| | - Tingting Zhao
- Reproductive Medicine Center, Shijiazhuang Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University, Shijiazhuang 050035, China
| |
Collapse
|
3
|
Sharami SH, Kabodmehri R, Milani F, Sorouri ZR, Ghanami N, Fatemeh Dalil S, Eslami-Kenarsari H. The prevalence of endometrial polyp in women with tubal factor infertility is higher than male factor infertility: Is PID one of the causes of endometrial polyp? J Obstet Gynaecol Res 2023; 49:658-664. [PMID: 36448572 DOI: 10.1111/jog.15485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/18/2022] [Accepted: 10/20/2022] [Indexed: 12/02/2022]
Abstract
AIMS Previous studies have shown an association between chronic endometritis and endometrial polyps, and only one study in infertile women reported an association between tubal obstruction and polyps. This study aimed to compare the prevalence of endometrial polyps in two groups of women with tubal factor infertility and male factor infertility to assess if is there any association between tubal factor infertility and endometrial polyps. METHODS This case-control study was performed on infertile women. The case group included women with tubal factor infertility and the control group included all women with male factor infertility. In all patients, vaginal ultrasound was performed between days 8 and 12 of the menstrual cycle to diagnose endometrial polyp, its size, and number. Demographic and obstetrics variables were recorded. Patients underwent hysteroscopy and polypectomy and the diagnosis of the polyp was confirmed by pathology report. RESULT In the present study, 245 people participated in two groups. There was a statistically significant difference between the two groups in terms of demographic and obstetric characteristics like type of infertility, duration of infertility, and gravidity. The prevalence of polyps in the tubal factor group was higher than in the male factor group (63 [60%] vs. 12 [9.8%]), and this difference was statistically significant (p = 0.0001). In addition, the prevalence of chronic endometritis in the tubal factor group was higher than in the male factor group (19 [18.8%] vs. 4 [3.3%]), and this difference was statistically significant (p = 0.001). CONCLUSIONS In the present study, a strong association was observed between endometrial polyps and tubal obstruction, and considering that the most common cause of tubal obstruction is pelvic and genital infections, after confirmation with more studies, it may be possible to consider antibiotic treatment in these patients, especially in patients with recurrent polyps.
Collapse
Affiliation(s)
- Seyedeh Hajar Sharami
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Roya Kabodmehri
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Forozan Milani
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Rafie Sorouri
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Nasrin Ghanami
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyedeh Fatemeh Dalil
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Habib Eslami-Kenarsari
- Vice-Chancellorship of Research and Technology, Guilan University of Medical Science, Rasht, Iran
| |
Collapse
|
4
|
Li XH, Lu MY, Niu JL, Zhu DY, Liu B. cfDNA Methylation Profiles and T-Cell Differentiation in Women with Endometrial Polyps. Cells 2022; 11:cells11243989. [PMID: 36552753 PMCID: PMC9777338 DOI: 10.3390/cells11243989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/30/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
DNA methylation is a part of the regulatory mechanisms of gene expression, including chromatin remodeling and the activity of microRNAs, which are involved in the regulation of T-cell differentiation and function. However, the role of cfDNA methylation in T-cell differentiation is entirely unknown. In patients with endometrial polyps (EPs), we have found an imbalance of T-cell differentiation and an aberrant cfDNA methylation profile, respectively. In this study, we investigated the relationship between cfDNA methylation profiles and T-cell differentiation in 14 people with EPs and 27 healthy controls. We found that several differentially methylated genes (DMGs) were associated with T-cell differentiation in people with EPs (ITGA2-Naïve CD4, r = -0.560, p = 0.037; CST9-EMRA CD4, r = -0.626, p = 0.017; and ZIM2-CM CD8, r = 0.576, p = 0.031), but not in healthy controls (all p > 0.05). When we combined the patients' characteristics, we found a significant association between ITGA2 methylation and polyp diameter (r = 0.562, p = 0.036), but this effect was lost when adjusting the level of Naïve CD4 T-cells (r = 0.038, p = 0.903). Moreover, the circulating sex hormone levels were associated with T-cell differentiation (estradiol-Naïve CD4, r = -0.589, p = 0.027), and the cfDNA methylation profile (testosterone-ZIM2, r = -0.656, p = 0.011). In conclusion, this study has established a link between cfDNA methylation profiles and T-cell differentiation among people with EPs, which may contribute to the etiology of EPs. Further functional studies are warranted.
Collapse
Affiliation(s)
- Xiao-Hong Li
- Department of Reproductive Health, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China
| | - Mei-Yin Lu
- Department of Biobank, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China
| | - Jia-Li Niu
- Department of Biobank, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China
| | - Dong-Yan Zhu
- Department of Biobank, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China
| | - Bin Liu
- Department of Biobank, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China
- Correspondence: ; Tel.: +86-158-1732-7996
| |
Collapse
|
5
|
Multivariate Analysis of Recurrence after Hysteroscopic Diagnosis and Treatment of Endometrial Polyps following IVF-ET Failure. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4140022. [PMID: 36159570 PMCID: PMC9492378 DOI: 10.1155/2022/4140022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022]
Abstract
Objective To explore the risk factors affecting the recurrence of endometrial polyps (EPs) after hysteroscopic diagnosis and treatment of EPs following in vitro fertilization-embryo transfer (IVF-ET) failure by multivariate analysis. Methods The clinical data of 369 patients with EPs hysteroscopically treated in our department due to IVF-ET failure from January 2017 to January 2020 were retrospectively analyzed, including the number and size of polyps, postoperative treatment, endometriosis (EM), hydrosalpinx (HSP), and polycystic ovarian syndrome (PCOS), and the effects of these factors on EP recurrence were observed. Results Of the patients enrolled, 184 cases (49.9%) were treated by curettage, and 185 cases (50.1%) by electrotomy. A total of 72 cases (19.5%) of postoperative recurrence were determined, including 34 cases (9.2%) without postoperative medication, 31 cases (8.4%) with one month of postoperative Didroxyprogesterone (DG) administration, and 7 cases (1.9%) with three months of postoperative DG administration. Surgical methods, 3 months of postoperative medication, PCOS, and polyp number and size significantly influence the recurrence of EPs, which were all the influencing factors of polyp recurrence. After controlling for other factors, the risk of EP recurrence after electrotomy was found to be lower than that after curettage, with an odds ratio (OR) (95% confidence interval (CI)) of 0.354 (0.163–0.767); the risk of EP recurrence after 3 months of postoperative medication was lower than that without postoperative medication, with an OR (95% CI) of 0.024 (0.005–0.104); the risk of EP recurrence in patients with PCOS was higher than that without PCOS, and the OR (95% CI) was 2.505 (1.113–5.639); patients with multiple polyps (≥2) were at an increased risk of recurrence than those with a single polyp, with an OR (95% CI) of 66.552 (14.711–301.084); patients with polyp diameter ≥ 2 cm had a higher risk of recurrence than those with polyp diameter < 2 cm, and the OR (95% CI) was 1084.76 (148.743–7910.999). Conclusions PCOS patients are at an elevated risk of EP recurrence than non-PCOS patients. In patients with multiple polyps, those with a diameter ≥ 2 cm have an increased risk of polyp recurrence compared with those with polyp diameter < 2 cm; electrotomy is associated with a lower recurrence risk of EPs than curettage. The risk of EP recurrence in patients treated with postoperative progesterone for 3 months is lower than that of patients without postoperative medication.
Collapse
|
6
|
Zhu N, Yang X, Liu Q, Chen Y, Wang X, Li H, Gao H. “Iron triangle” of regulating the uterine microecology: Endometrial microbiota, immunity and endometrium. Front Immunol 2022; 13:928475. [PMID: 36016947 PMCID: PMC9396262 DOI: 10.3389/fimmu.2022.928475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
The uterus is the core place for breeding new life. The balance and imbalance of uterine microecology can directly affect or even dominate the female reproductive health. Emerging data demonstrate that endometrial microbiota, endometrium and immunity play an irreplaceable role in regulating uterine microecology, forming a dynamic iron triangle relationship. Up to nowadays, it remains unclear how the three factors affect and interact with each other, which is also a frontier topic in the emerging field of reproductive tract microecology. From this new perspective, we aim to clarify the relationship and mechanism of the interaction of these three factors, especially their pairwise interactions. Finally, the limitations and future perspectives of the current studies are summarized. In general, these three factors have a dynamic relationship of mutual dependence, promotion and restriction under the physiological or pathological conditions of uterus, among which the regulatory mechanism of microbiota and immunity plays a role of bridge. These findings can provide new insights and measures for the regulation of uterine microecology, the prevention and treatment of endometrial diseases, and the further multi-disciplinary integration between microbiology, immunology and reproductive medicine.
Collapse
Affiliation(s)
- Na Zhu
- Department of Nursing, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- School of Nursing, University of South China, Hengyang, China
| | - Xuyan Yang
- Department of Nursing, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Qiao Liu
- School of Nursing, University of South China, Hengyang, China
| | - Yahui Chen
- School of Nursing, University of South China, Hengyang, China
| | - Xiaolan Wang
- Center for Reproductive Medicine, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Huanhuan Li
- Department of Gynecology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Hong Gao
- Department of Nursing, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- *Correspondence: Hong Gao,
| |
Collapse
|
7
|
Lan J, Chen C, Chen L, Liu P. Intestinal Microflora Provides Biomarkers for Infertile Women with Endometrial Polyps. Biomarkers 2022; 27:579-586. [PMID: 35546106 DOI: 10.1080/1354750x.2022.2077445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Endometrial polyps (EPs) are related to infertility; however, there are no biomarkers for identification. We evaluated changes in the intestinal microflora to identify microflora-based biomarkers that may be useful for detecting EPs. Intestinal specimens were prospectively collected from 100 women: 25 infertile women with EPs (InfEP + group), 25 infertile women without EPs (InfEP- group), and 50 healthy women (Fertile group). The microbiota composition was analyzed using 16S ribosomal RNA gene amplification and the intestinal expression of selected human genes using quantitative reverse transcription polymerase chain reaction. The InfEP + group had higher proportions of Prevotella, Streptococcus, Fusobacterium, Fenollaria, and Porphyromonas than the InfEP- and Fertile groups, while the Fertile group had higher proportions of Faecalibacterium, Bacteroides, and Blautia. We constructed a microbial dysbiosis index based on the intestinal microbiota at the genus level as a predictive model. The most accurate model to predict the presence of EPs was that including the Fertile and InfEP + groups (area under the curve: 0.89, 95% confidence interval: 0.79-0.96). The InfEP- and Fertile groups had significant differences in microflora composition compared with the InfEP + group. The intestinal microflora may be a useful biomarker for identifying EPs in infertile women.
Collapse
Affiliation(s)
- Jun Lan
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Dadao North Road, Baiyun District, Guangzhou City 510000, Guangdong Province, China.,Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Dong Guan, 99 Zhenxing Road, Dongguan City, Guangdong Province, Dongguan, 523000, China
| | - Chunlin Chen
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Dadao North Road, Baiyun District, Guangzhou City 510000, Guangdong Province, China
| | - Ling Chen
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Dadao North Road, Baiyun District, Guangzhou City 510000, Guangdong Province, China
| | - Ping Liu
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Dadao North Road, Baiyun District, Guangzhou City 510000, Guangdong Province, China
| |
Collapse
|
8
|
Li XH, Lu MY, Li YJ, Liu ZH, Yin ZN, Liu B, Wu YZ. Circulating PD1 +Vδ1 +γδ T Cell Predicts Fertility in Endometrial Polyp Patients of Reproductive-Age. Front Immunol 2021; 12:639221. [PMID: 34211457 PMCID: PMC8239402 DOI: 10.3389/fimmu.2021.639221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
Clinically, immune cell function is correlated with pathogenesis of endometrial polyp (EP) and infertility of women of reproductive-age. However, the underlying immune cell hallmark in EP patients remains unclear. Here, we focused on analyzing circulating immune cells, and attempted to reveal the correlation between peripheral immune cell functional phenotypes and fertility in EP patients. Through comparison of circulating CD4+/CD8+ T cells, NK cells, and γδ T cells between 64 EP patients and 68 healthy females, we found that γδ T cells, but not CD4+/CD8+ T cells and NK cells, were immunologically correlated with conception rate and conception interval time. Specifically, total γδ T cells and the Vδ1+PD1+ γδ T subpopulation decreased whereas the Vδ1/Vδ2 ratio increased in EP patients compared to healthy controls. Moreover, the patients with the higher Vδ1/Vδ2 ratio (median value equals 1.04) had a poorer fertility and longer interval time of conception (210 days versus 158 days for control). Meanwhile, higher Vδ1+PD1+ γδ T cell proportion (median equals 15.7) was positively correlative with both higher conception rate and shortened median conception interval time (130 days for Vδ1+PD1high group versus 194 days for Vδ1+PD1low group). Notably, in healthy controls, both Vδ1/Vδ2 ratio and Vδ1+PD1+ γδ T cell proportion correlated with pregnancy rate oppositely, comparing to EP patients. Together, our results suggested that imbalanced γδ T cell population occurred in EP patients, and that Vδ1/Vδ2 ratio and PD-1 expression of Vδ1+ γδ T cells could be potentially developed into valuable predictors for fertility in EP patients.
Collapse
Affiliation(s)
- Xiao-Hong Li
- Department of Obstetrics and Gynecology, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen, China
| | - Mei-Yin Lu
- Department of Biobank, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen, China
| | - Yi-jia Li
- Zhuhai Institute of Translational Medicine, Zhuhai People’s Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, China
| | - Zong-hua Liu
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, China
| | - Zhi-nan Yin
- Zhuhai Institute of Translational Medicine, Zhuhai People’s Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, China
| | - Bin Liu
- Department of Biobank, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen, China
| | - Yang-zhe Wu
- Zhuhai Institute of Translational Medicine, Zhuhai People’s Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
| |
Collapse
|
9
|
Guo L, Gu F, Tan J, Luo L, Gao J, Zhou C. Multiple endometrial polyps is associated with higher risk of chronic endometritis in reproductive-aged women. J Obstet Gynaecol Res 2020; 47:389-396. [PMID: 33300233 DOI: 10.1111/jog.14541] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/13/2020] [Accepted: 10/16/2020] [Indexed: 01/31/2023]
Abstract
AIM To determine whether single endometrial polyp (EP) or multiple EP (polyp number ≥ 6) are associated with chronic endometritis (CE). METHODS From June 2017 to December 2018, this study enrolled a total of 277 patients, including 92 patients with multiple EP, 82 patients with a single EP and 103 patients without polyps who underwent hysteroscopic examination and polypectomy. Polyps and endometrium samples were obtained and subjected to immunohistochemistry for CD138 to identify plasma cells and CE was diagnosed as CD138-positive plasma cells greater than or equal to 5/high power field. The prevalence of CE was compared and analyzed using the logistic regression model. RESULTS All baseline parameters were comparable among the three groups except that the prevalence of abnormal uterine bleeding (AUB) was much higher in both polyp groups than the non-polyp control. The prevalence of CE was significantly higher in the multiple EP group than in the single EP group (58.7% vs 28.0%, P < 0.001). There was no difference on the prevalence of CE between the single EP and the non-polyp groups (28.0% vs 29.1%, P = 0.872). Multivariable analysis revealed that AUB (adjusted OR 2.81, 95% CI 1.35-5.87) and multiple EP (adjusted OR 2.58, 95% CI 1.38-4.82) were independently associated with CE, while the single EP did not increase the odds of CE compared to the non-polyp group (adjusted OR 0.74, 95% CI 0.38-1.45). CONCLUSION Multiple EP were positively associated with CE among reproductive-aged women, suggesting a possible hidden etiopathogenetic link between chronic inflammation and multiple EP.
Collapse
Affiliation(s)
- Luyan Guo
- Department of Obstetrics and Gynecology, Reproductive Medical Center, Guangzhou, China
| | - Fang Gu
- Department of Obstetrics and Gynecology, Reproductive Medical Center, Guangzhou, China
| | - Jinfeng Tan
- Division of Gynecology, Department of Obstetrics and Gynecology, The First Affiliated Hospital Sun Yat-sen University, Guangzhou, China
| | - Lu Luo
- Department of Obstetrics and Gynecology, Reproductive Medical Center, Guangzhou, China
| | - Jun Gao
- Department of Obstetrics and Gynecology, Reproductive Medical Center, Guangzhou, China
| | - Canquan Zhou
- Department of Obstetrics and Gynecology, Reproductive Medical Center, Guangzhou, China.,Key Laboratory of Reproductive Medicine of Guangdong Province, Guangzhou, China
| |
Collapse
|
10
|
TGF-β1 role in uterine leiomyoma and endometrial polyp: an insight to drug-based treatment instead of surgical techniques. Obstet Gynecol Sci 2020; 64:107-113. [PMID: 33238661 PMCID: PMC7834754 DOI: 10.5468/ogs.20191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/08/2020] [Indexed: 01/04/2023] Open
Abstract
Objective Considering the high prevalence of leiomyoma and endometrial polyps, investigating the contributing factors and determining the pathophysiology of these lesions are essential. Target therapy is now an acceptable method for the treatment of some diseases. We aimed to determine the expression of transforming growth factor (TGF)-β1 in endometrial polyps and leiomyomas to discover a drug-based method to overcome surgical treatments. Methods In this cross-sectional study, 55 patients with leiomyoma and 55 patients with polyps were included. Prepared slides from leiomyoma and adjacent myometrium or polyp lesions and adjacent endometrium were obtained and investigated for TGF-β1. Then, data were collected and analyzed using SPSS version 22. Results The mean age of participants was 40.6±5.8 years. Based on their reports, 88.2% (n=97) of patients in the study population had abnormal uterine bleeding with similar distributions among both groups. In contrast, 63.5% of the leiomyoma group did not express TGF-β1. However, in normal myometrium, 23.6% had the highest degree of TGF-β1 expression. Polyp tissue did not show staining for TGF-β1 in any patients. Additionally, 89.1% of non-polypoid endometrium did not express TGF-β1. Normal tissue had a significantly greater amount of TGF-β1 compared to leiomyoma and endometrial polyps. Conclusion TGF-β1 is expressed more prominently in normal myometrium with mostly high-intensity features compared to leiomyoma. Additionally, polyps showed no staining for TGF-β1, while normal endometrium showed a low-density staining pattern.
Collapse
|
11
|
Ciscato A, Zare SY, Fadare O. The significance of recurrence in endometrial polyps: a clinicopathologic analysis. Hum Pathol 2020; 100:38-44. [PMID: 32334830 DOI: 10.1016/j.humpath.2020.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 11/30/2022]
Abstract
A subset of endometrial polyps recurs after resection. The clinicopathologic significance of the phenomenon is evaluated herein. Consecutive cases of recurrent polyps (index polyp removed by hysteroscopy-directed polypectomy or by curettage; at least one more polyp diagnosed ≤12 months after) were compared with an age-matched control group of nonrecurrent polyps regarding 15 clinicopathologic features. A total of 107 (5.6%) of the 1908 polyps diagnosed in a sampling specimen during the study period was a recurrence, and 102 (6.9%) of the 1478 patients who were diagnosed with an endometrial polyp in a sampling specimen had at least 1 recurrence. Eighty-six percent of patients with any recurrences had only one recurrence, with a mean duration between the index polyp and the first recurrence of 4.36 months. On univariate analyses, the recurrent polyps were, compared with controls, significantly larger, had a higher stromal mitotic index, and more frequently displayed prominent thick-walled vessels in most fragments of the polyp. However, on Cox regression multivariate analyses, no single clinicopathologic feature was significantly associated with a recurrence. No malignancies were diagnosed during the follow-up of the study and control group patients at median follow-up durations of 23 and 34 months, respectively. In conclusion, the recurrence of an endometrial polyp is relatively uncommon (5.6% of polyps) and does not portend an increased risk of malignancy. We could not identify any clinicopathologic features that conclusively predict a recurrence.
Collapse
Affiliation(s)
- Andreas Ciscato
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Somaye Y Zare
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Oluwole Fadare
- Department of Pathology, University of California San Diego, La Jolla, CA, USA.
| |
Collapse
|
12
|
Takeda T, Banno K, Kobayashi Y, Adachi M, Yanokura M, Tominaga E, Kosaki K, Aoki D. Mutations of RAS genes in endometrial polyps. Oncol Rep 2019; 42:2303-2308. [PMID: 31638232 PMCID: PMC6826305 DOI: 10.3892/or.2019.7353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/27/2019] [Indexed: 11/05/2022] Open
Abstract
Endometrial polyps are common, yet the molecular mechanisms underlying their formation and progression remain unclear. We examined gene mutations possibly related to the pathogenesis of endometrial polyps, as well as to their clinical features. Four premenopausal patients with endometrial polyps, who were not under drug treatment, were recruited. Whole exomes of endometrial polyps and peripheral blood lymphocytes were analyzed by next‑generation sequencing, and somatic mutations were derived by subtraction. Then, 35 samples of endometrial polyps and 12 samples of atypical polypoid adenomyoma were newly recruited to validate the identified mutations by polymerase chain reaction‑reverse sequence specific oligonucleotide method. The mutations were also analyzed in separate stromal and glandular components of the polyps after laser‑capture microdissection. Whole exome sequencing revealed that KRAS mutations were the only type of mutation detectable in multiple cases (2/4). Targeted mutation analysis revealed that 16 of 35 samples (45.7%) of endometrial polyps harbored RAS mutations. Mutation‑positive cases exhibited a significantly higher number of endometrial polyps (3.25±2.70 vs. 1.74±0.87, P=0.045). Laser‑capture microdissection in NRAS‑mutated endometrial polyps revealed that both stromal and glandular components harbored RAS mutations. There was no RAS mutation in 12 samples of atypical polypoid adenomyoma. This is the first report demonstrating that pathogenic RAS mutations are frequent in non‑treated endometrial polyps. RAS mutations may have an important role in tumorigenesis and in the formation of multiple endometrial polyps.
Collapse
Affiliation(s)
- Takashi Takeda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160‑8582, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160‑8582, Japan
| | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160‑8582, Japan
| | - Masataka Adachi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160‑8582, Japan
| | - Megumi Yanokura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160‑8582, Japan
| | - Eiichiro Tominaga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160‑8582, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo 160‑8582, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160‑8582, Japan
| |
Collapse
|
13
|
Recurrent endometrial polyps – influencing factors and treatment. GINECOLOGIA.RO 2019. [DOI: 10.26416/gine.23.1.2019.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|