Endometrial BCL6 Overexpression in Eutopic Endometrium of Women With Endometriosis

Emily Evans-Hoeker, Ricardo Francalacci Savaris, Wilder A. Palomino, David P. Schammel, Jae Wook Jeong, Lingwen Yuan, Bruce A. Lessey, Steven L. Young
2020 · doi:10.17615/pra0-cj05 · W4299561404
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BCL6 protein expression was significantly higher in the secretory phase of women with endometriosis and unexplained infertility, identifying a potential diagnostic biomarker.

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This study examined B-cell CLL/lymphoma 6 (BCL6) expression in human eutopic endometrium across the menstrual cycle in women with and without endometriosis, using prospectively collected samples from tertiary hospitals. BCL6 was measured by messenger RNA and immunohistochemistry in both proliferative and secretory phases, and the authors established a cutoff intended for use in future studies. They found BCL6 protein expression was significantly higher in the secretory phase in women with endometriosis (n=29) versus fertile controls without endometriosis at laparoscopy (n=20), and that fertile controls had low secretory-phase BCL6 compared with women with unexplained infertility (n=119); an ROC analysis yielded an area under the curve of 94% with an HSCORE cutoff of 1.4. The authors report high agreement when a subset of 65 underwent laparoscopy, but the study is limited by its case-control design and focus on selecting thresholds from the collected cohort. This paper is centrally about endometriosis—specifically, it tests endometrial BCL6 overexpression in eutopic endometrium as a diagnostic biomarker distinguishing endometriosis from controls.

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Abstract

The objective of this study was to examine B-cell CLL/lymphoma 6 (BCL6) expression in human eutopic endometrium across the menstrual cycle in women with and without endometriosis and to establish a cutoff for future studies. This design was a series of case-control studies in tertiary University teaching hospitals. We examined BCL6 expression by messenger RNA and immunohistochemically in prospectively collected samples in both the proliferative (P) and the secretory phases. BCL6 is minimally increased in the mid-secretory phase of the menstrual cycle compared to the P phase in normal patients. BCL6 protein expression was significantly higher in the secretory phase of patients with endometriosis (n = 29) versus fertile controls without endometriosis at laparoscopy (n = 20; P < .0001). Normal fertile controls (n = 28) recruited for endometrial biopsy also had low levels of secretory phase BCL6 expression compared to women with unexplained infertility (UI; n = 119). A receiving-operator characteristic analysis of these data revealed an area under the curve of 94% (95% confidence interval 85%-100%; P < .0001) with an HSCORE cutoff of 1.4 to differentiate cases with and without endometriosis. Using this cutoff value, BCL6 was positive in 88% of cases with UI. Laparoscopic examination of a subset of 65 patients confirmed abnormalities in 98% of cases; 61 (93.8%) were found to have endometriosis, 3 (4.6%) with hydrosalpinx, and 1 (1.5%) with a normal pelvis. These data suggest that BCL6 is a promising candidate as a single diagnostic biomarker for detection of endometriosis in women with otherwise UI and may be associated with endometrial dysfunction, including progesterone resistance
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Endometrial BCL6 Overexpression in Eutopic Endometrium of Women With Endometriosis Public DepositedAdd to collection You do not have access to any existing collections. You may create a new collection. Downloadable Content Download PDFCitation MLA Evans Hoeker, Emily, et al. Endometrial Bcl6 Overexpression In Eutopic Endometrium of Women With Endometriosis. 2016. https://doi.org/10.17615/pra0-cj05APA Evans Hoeker, E., Lessey, B., Jeong, J., Savaris, R., Palomino, W., Yuan, L., Schammel, D., & Young, S. (2016). Endometrial BCL6 Overexpression in Eutopic Endometrium of Women With Endometriosis. https://doi.org/10.17615/pra0-cj05Chicago Evans Hoeker, Emily, Bruce A Lessey, Jae Wook Jeong, Ricardo F Savaris, Wilder A Palomino, Lingwen Yuan, David P Schammel et al. 2016. Endometrial Bcl6 Overexpression In Eutopic Endometrium of Women With Endometriosis. https://doi.org/10.17615/pra0-cj05- Creator - Evans-Hoeker, Emily - School of Medicine, Department of Obstetrics and Gynecology - Other Affiliation: Obstetrics and Gynecology; Carilion Clinic; Virginia Tech Carilion School of Medicine - Lessey, Bruce A. - Other Affiliation: Obstetrics and Gynecology; Greenville Health System - Jeong, Jae Wook - Other Affiliation: Obstetrics; Gynecology and Reproductive Biology of Michigan; State University - Savaris, Ricardo F. - Other Affiliation: Departamento de Ginecologia e Obstetricia; Universidade Federal Do Rio Grande Do sul - Palomino, Wilder A. - Other Affiliation: Institute for Maternal and Child Research; University of Chile - Yuan, Lingwen - School of Medicine, Department of Obstetrics and Gynecology - Schammel, David P. - Other Affiliation: Pathology Assoct.; Greenville Health System - Young, Steven L. - School of Medicine, Department of Obstetrics and Gynecology - Evans-Hoeker, Emily - Abstract - The objective of this study was to examine B-cell CLL/lymphoma 6 (BCL6) expression in human eutopic endometrium across the menstrual cycle in women with and without endometriosis and to establish a cutoff for future studies. This design was a series of case-control studies in tertiary University teaching hospitals. We examined BCL6 expression by messenger RNA and immunohistochemically in prospectively collected samples in both the proliferative (P) and the secretory phases. BCL6 is minimally increased in the mid-secretory phase of the menstrual cycle compared to the P phase in normal patients. BCL6 protein expression was significantly higher in the secretory phase of patients with endometriosis (n = 29) versus fertile controls without endometriosis at laparoscopy (n = 20; P < .0001). Normal fertile controls (n = 28) recruited for endometrial biopsy also had low levels of secretory phase BCL6 expression compared to women with unexplained infertility (UI; n = 119). A receiving-operator characteristic analysis of these data revealed an area under the curve of 94% (95% confidence interval 85%-100%; P < .0001) with an HSCORE cutoff of 1.4 to differentiate cases with and without endometriosis. Using this cutoff value, BCL6 was positive in 88% of cases with UI. Laparoscopic examination of a subset of 65 patients confirmed abnormalities in 98% of cases; 61 (93.8%) were found to have endometriosis, 3 (4.6%) with hydrosalpinx, and 1 (1.5%) with a normal pelvis. These data suggest that BCL6 is a promising candidate as a single diagnostic biomarker for detection of endometriosis in women with otherwise UI and may be associated with endometrial dysfunction, including progesterone resistance - Date of publication - 2016 - Keyword - DOI - Identifier - Publisher DOI: https://doi.org/10.1177/1933719116649711 - Onescience id: b29047364c917555c3ea0de644cca7c6603b8121 - PMCID: PMC5933165 - PMID: 27222232 - Resource type - Article - Rights statement - In Copyright - Journal title - Reproductive Sciences (Thousand Oaks, CA) - Journal volume - 23 - Journal issue - 9 - Language - English - ISSN - 1933-7191 - 1933-7205 Relations - Parents: This work has no parents. Items | Thumbnail | Title | Date Uploaded | Visibility | Actions | |---|---|---|---|---| | PubMedCentral-PMC5933165.pdf | 2016 | Public | Download |

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