Morphologic Evaluation of Pelvic Endometriosis

Autoimmune phenomenon have previously been described in patients with pelvic endometriosis.Anti-endometrial antibodies have been observed, as well as increased numbers of macrophages and lymphocytes in the peritoneal fluid.These findings may suggest a cell-mediated immune response.To explore this concept, the present study quantitated T and B lymphocytes and T lymphocyte subsets in the peritoneal fluid and peripheral blood of patients with endometriosis.These results were compared to those in a control group of patients with no evidence of endometriosis.The results demonstrated increased numbers of T and B cells in the peritoneal fluid and peripheral blood of patients with endometriosis (peritoneal fluid = 30 5 % T, 27 6 % B; peripheral blood = 40 10% T, 22 6% B) as compared to controls (peritoneal fluid = 22 5% T, 14 3% B, peripheral blood = 27 7 % T, 11 3 % B).Furthermore, the 4/Ts ratio was significantly increased in patients with endometriosis (peritoneal fluid 2.71 1.23 vs control 1.69 0.74; peripheral blood 2.20 0.89 vs control 1.54 0.58).We suggest that the presence of increased T and B lymphocytes in patients with endometriosis lends support to the concept of a cell-mediated autoimmune reactions in some patients.