Expression of aromatase in endometiosis and its relation to clinical laboratory and surgical parameters

Il-Han Lee, Dong-Ho Kim, Ji Hyun Noh, Jae Whoan Koh, Yong Bong Kim
In: Korean Journal of Obstetrics and Gynecology · 2010 · vol. 53(4) , pp. 346 · doi:10.5468/kjog.2010.53.4.346 · W2057596588
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Aromatase expression was higher in endometriotic lesions and eutopic endometrium compared to healthy controls, correlating with increased pain, CA-125 levels, and endometriosis severity.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This study evaluated aromatase expression in eutopic endometrium and endometriotic lesions and analyzed associations with clinical symptoms, laboratory markers, and operative findings. Tissue from 78 endometriotic lesion cases, 14 eutopic endometrium cases, and 30 normal endometrium controls obtained during laparoscopic surgery and curettage were assessed by immunohistochemistry for aromatase, then compared across clinical and laboratory parameters. Aromatase was immunopositive in 46/78 endometriotic lesion patients (59.0%), with higher expression in endometriosis-related eutopic endometrium versus eutopic tissue from patients without endometriosis, and aromatase-positive patients showed more moderate-to-severe chronic pelvic pain and higher CA-125, alongside more frequent severe disease features (e.g., severe grade endometriosis, bilateral endometriomas) and co-associated leiomyoma and adenomyosis. This paper is centrally about endometriosis—measuring aromatase expression in endometriotic lesions and eutopic endometrium and relating it to symptom severity and surgical/laboratory parameters, with adenomyosis noted as an associated uterine estrogen-driven condition.

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Abstract

Objective: Aromatase is the key enzyme for the conversion of C19 steroids into estrogen in certain human tissues. We studied to evaluate the aromatase expression in eutopic endometirum and endometriotic lesion and its relationship to clinical and laboratory parameters. Methods: The study included 78 cases of endometriotic lesion and 14 cases of eutopic endometrium and 30 cases of normal uterine endometrium obtained through laparoscopic surgery and curettage. The frozen tissue specimens were examined by immunohistochemistry using aromatase. Clinical symptoms, laboratory findings, and operative findings were analyzed and compared in according to aromatase expression. Results: We observed positive immunohistochemical expression for aromatase in endometriotic lesion from 46/78 patients (59.0%). Aromatase expression was elevated in comparison to eutopic endometrium (5/14 patients, P=0.032) and the difference was more pronounced when eutopic endometriums from patients with endometriosis were compared with those of healthy controls (2/30 patients, P<0.001). Aromatase-positive patients had more moderate-to-severe chronic pelvic pain, higher CA-125 level significantly. Also in operative findings, severe grade endometriosis, bilateral endometriomas, and associated leiomyoma and adenomyosis were more frequent in aromatase positive patients. High values of white blood cell count, erythrocyte sedimentation rate, CA 19-9 were more frequent in aromatase positive patients notwithstanding insignificant differences. Conclusion: Unopposed local biosynthesis of estrogens by increased expression of aromatase in eutopic endometrium and endometrial tissue could be involved in the development or maintenance of endometriosis and other uterine estrogen-triggered diseases. Our findings suggest increased expression of aromatase may be related with severity, activity, and chronic pelvic pain in patients with endometriosis.

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endometriosisadenomyosischronic_pelvic_pain

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