The importance of endometrial nerve fibers and macrophage cell count in\nthe diagnosis of endometriosis

Background: Endometriosis is a disease that is hard to diagnose without\nthe gold standard method, laparoscopy. An easier diagnostic method is\nneeded. Objective: The aim of the study is to determine whether the\nnumber of macrophage cells in the endometrium and/or the detection of\nnerve fibers can be used in the diagnosis of endometriosis. Materials\nand Methods: Endometrial sampling was done to 31 patients prior to\nlaparoscopy (L/S) or laparotomy (L/T) at Istanbul University Istanbul\nSchool of Medicine Hospital between January 2010 February 2011. Also 34\npatients who were retrospectively chosen from their files were added to\nthe study. 5 patients were excluded from the study. Totally, 31\npatients were placed in the endometriosis and 29 patients in the\ncontrol group. Endometrial samples were evaluated immunohistochemically\nwith the markers protein gene product 9.5 (PGP 9.5) and neurofilament\n(NF) for nerve fibers and CD68 for macrophages. Results: None of the\nsamples were stained with PGP 9.5 and NF. As for CD68+cells, no\nstatistically significant difference was observed between groups\n(endometriosis: 216.10±104.41; control: 175.93±43.05,\np=0.06). Results were also evaluated in the subgroups of menstruel\nphases and disease stages. Only in the proliferative phase there was a\nsignificant increase in the endometriosis group (p=0.03). No\nsignificant difference was observed between the stages. Conclusion: The\ndetection of nerve fibers in the eutopic endometrium with the markers\nof PGP 9.5 and NF is not found to be helpful in the diagnosis of\nendometriosis. Macrophage cells may be helpful in the diagnosis only in\nthe proliferative phase.