Features of epithelial-mesenchymal transition in ectopic endometrium in patients with extragenital endometriosis of various localizations. Observational study

Cazacu, Eugeniu, Zota, Eremei, Mariam A. Vardanyan, Niguleanu, Radu, Pretula, Ruslan, A.V. Asaturova, Ezhova L.S. Ezhova, Алина Бадлаева
In: Gynecology · 2024 · vol. 26(2) , pp. 159–164 · doi:10.26442/20795696.2024.2.202799 · W4399480580
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This study analyzed extragenital endometriosis in various locations and found that diffuse infiltrative forms exhibited low E-cadherin and high Vimentin expression, confirming epithelial-mesenchymal transition and invasive potential.

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

This observational study analyzed 43 cases of extragenital endometriosis from appendiceal, colonic/ileal, inguinal hernia sac, and abdominal scar after caesarean section localizations to assess epithelial-mesenchymal transition (EMT) features. Using histology and immunohistochemistry on paraffin-embedded postoperative material, the authors measured E-cadherin and vimentin expression as markers of epithelial versus mesenchymal phenotypes, reporting E-cadherin/vimentin expression ratios that were higher in peritoneal and bowel sites and lower (notably) in diffuse infiltrative forms. They found that diffuse infiltrative endometriosis lesions showed low E-cadherin expression with high vimentin expression (p<0.05), and concluded this supports EMT involvement and invasive potential, while the main limitation is that the study is semi-quantitative and observational without functional validation of causality. Relevance to endometriosis: the paper is centrally about endometriosis—specifically EMT markers (E-cadherin/vimentin) in ectopic endometrium from extragenital endometriosis of multiple localizations.

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Abstract

Background. Epithelial-mesenchymal transition (EMT) is a conserved mechanism in the process of morphogenesis and organogenesis. EMT provides cells with migratory and invasive properties, which is a necessary condition for the formation of endometrioid heterotopias. Aim. To confirm the presence of EMT features in different types of endometriosis. Materials and methods. During a period of five years (2012–2017) we analyzed 43 cases of extragenital endometriosis: appendix (3 case), colon (5 cases), ileum (1 case), abdominal scar endometriosis after caesarean section (24 cases), and inguinal hernia (10 cases). The material was processed according to histological and immunohistochemical technique using monoclonal E-cadherin and polyclonal Vimentin antibodies to assess local invasiveness. Results. In peritoneal endometriosis, the ratio of E-cadherin to Vimentin expression was 10.3, in the colon = 9.1, in the appendix 8.6, in the ileum 5.5, in the hernial sac 4.2. Thus, in diffuse infiltrative forms of endometriosis, the lesion phenotype is characterized by low expression of E-cadherin, while expression of Vimentin is at a high level (p0.05). Conclusion. The results of our study confirmed involvement of the epithelial-mesenchymal transition process in the pathogenesis of extragenital endometriosis lesions, on the one hand, and they certify its invasive potential in these localizations, on the other hand.

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endometriosis

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