Detection of endometriosis using immunocytochemistry of P450 Aromatase expressions in eutopic endometrial cells obtained from menstrual sloughing: a diagnostic study

Tita Husnitawati Madjid, Jumadi, Jumadi Jumadi, Raden Tina Dewi Judistiani, Bethy Suryawathy Hernowo, Ahmad Faried
BMC research notes · 2020 · vol. 13(1) , pp. 233 · doi:10.1186/s13104-020-05070-w · PMID:32345338 · W3018187213
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Immunocytochemistry scoring of Aromatase P450 expression in menstrual endometrial cells achieved high sensitivity and specificity for detecting endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This case-control diagnostic study evaluated whether immunocytochemistry scoring of P450 aromatase (ICAPEC) in eutopic endometrial cells collected from menstrual sloughing could distinguish women with and without endometriosis, comparing ICAPEC against histopathological confirmation from surgical specimens across multiple Indonesian hospitals. Menstrual blood (day 1–2) was processed into smears for aromatase immunocytochemistry, and aromatase intensity/distribution was summarized using H-scores, with performance estimated at a predefined cut-off (>4). Women with endometriosis had significantly stronger aromatase expression in menstrual blood-derived endometrial cells, and the H-score cut-off of >4 yielded 94.6% sensitivity, 90.9% specificity, 92% positive predictive value, and 93% negative predictive value, with a stated limitation that the study depended on surgical/histopathology confirmation and a relatively small, selected case-control sample. This paper is centrally about endometriosis — specifically, it tests menstrual blood–derived eutopic endometrial aromatase immunocytochemistry as a non-invasive diagnostic approach for endometriosis.

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Abstract

OBJECTIVE: To explore the possibility of a new diagnostic approach of endometriosis based on immunocytochemistry scoring of Aromatase P450 expressions in endometrial cells collected from menstrual sloughing. This is a case control study. Immuncytochemistry scores vs. histopathological examination in one tertiary- and secondary-level hospital in Bandung; two secondary level hospital in Garut and Sumedang, West Java, Indonesia. Thirty-five patients with and without endometriosis were enrolled. All subjects had diagnostic procedures for endometriosis suspicion, with addition menstrual blood samples for cytopathological examination. The specimens were sent for immunocytochemistry assessment of P450 Aromatase expressions (ICAPEC). The previous procedure resulted in cut-off point of histo score (H-score), sensitivity, specificity, (+) and (-) ICAPEC predictive value. RESULTS: The P450 Aromatase expression in endometrial cells of women with endometriosis was significantly stronger than without one. The cut-off point of H-scores to detect endometriosis was > 4. By this criteria, H-score had 94.6% sensitivity, 90.9% specificity, 92% positive predictive value and 93% negative predictive value. Immunocytochemistry scoring of Aromatase P450 expression in endometrial cells (ICAPEC) derived from menstrual blood specimen was a good candidate as alternatives approach in diagnostic procedure of endometriosis. Application and evaluation in clinical practice would provide the economically benefit in diagnostic procedure.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Aromatase Endometriosis Endometriosis Endometrium Menstruation Adolescent Adult Aromatase Case-Control Studies Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Female Humans Immunohistochemistry Indonesia Menstruation

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