Assessment of Nerve Fiber Density and Expression of Hormonal Receptors Within Rectosigmoid Endometriosis Nodules

Zomer MT, Monica Tessmann Zomer, William Kondo, Kondo W, Cavalcanti TCS, Teresa Cristina Santos Cavalcanti, Renate Von Linsigen, Von Linsigen R, Luiz Rodrigo Guimaraes Ferreira, Ferreira LRG, Carranco RC, Ramiro Cabrera, Ramiro Cabrera Carranco, Trippia CH, Carlos Henrique Trippia, Kulak J Jr, Jaime Kulak
Journal of minimally invasive gynecology · 2021 · vol. 29(2) , pp. 265–273 · doi:10.1016/j.jmig.2021.08.008 · PMID:34411730 · W3195889361
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This study investigated nerve fiber density and hormonal receptor expression in rectosigmoid endometriosis nodules to understand their potential role in disease pathogenesis and pain.

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Abstract

Study objectiveTo assess nerve fiber density and expression of hormone receptors in bowel endometriosis.DesignCross-sectional study.SettingPrivate hospital.PatientsWomen with endometriosis undergoing laparoscopic segmental bowel resection (n = 54).InterventionsTissue samples were obtained from patients with surgically treated rectosigmoid endometriosis.Measurements and main resultsThe rectosigmoid specimen containing the endometriosis nodule was manually sectioned and divided into 3 areas: core of the nodule, margin of the nodule, and healthy bowel tissue. The intensity of expression of estrogen and progesterone receptors was evaluated by immunohistochemistry and measured according to the Allred score. Nerve fibers were stained by immunohistochemistry using Protein Gene Product 9.5, and the density of nerve fillets was counted and expressed in number/mm². All glandular and stromal cells stained for estrogen; however, glandular cells stained more strongly than stromal cells (61.1% vs 35.2%; p = .01). Most of glandular and stromal cells stained strongly for progesterone receptors (90.7% vs 98.1%; p = .2). The density of nerve fibers was very high in the margin of the nodule (172.22±45.66/mm²), moderate in healthy bowel tissue (111.48±48.57/mm²), and very low in the core of the nodule (7.31±4.9/mm²); p = .01.ConclusionBoth glandular and stromal cells within the rectosigmoid endometriosis nodule express estrogen and progesterone receptors. Higher intensity of expression of estrogen receptors occurs in glandular cells. The density of nerve fibers is extremely high at the nodule margin and very low in the center of the nodule.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Rectal Diseases Rectal Diseases Cross-Sectional Studies Female Humans Nerve Fibers Nerve Fibers Rectum Rectum

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