Endometrial hyperplasia in women with external genital endometriosis and uterine myoma
Endometrial hyperplasia without atypia in infertile women with external genital endometriosis or uterine myoma was associated with chronic endometritis, desynchronization, and reduced endometrial receptor expression.
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The paper studied endometrial morphology in 142 reproductive-age women with histologically confirmed endometrial hyperplasia without atypia, comparing 74 women with secondary infertility plus external genital endometriosis (stage I–II) versus 68 women with secondary infertility plus uterine myoma (intramural or subserosal nodes ≤3 cm). Using endometrial biopsies taken on defined cycle days, the authors assessed chronic endometritis (histology plus immunohistochemistry for CD8+, CD20+, CD4+, CD138+ and related fibrotic/sclerotic features), analyzed p16INK4a expression, and measured ERα and PR expression patterns by immunohistochemistry/immunofluorescence, including an explicit limitation that morphologic verification is the long-standing “gold standard.” They found chronic endometritis in 83.8% with endometriosis and 86.8% with myoma, while p16INK4a was positive in all patients; ERα/PR expression was often uniformly distributed but became uneven and decreased in association with fibrosis and endometritis. Relevance to endometriosis: the study directly compares endometrial hyperplasia in women with external genital endometriosis (plus infertility) to those with myoma, focusing on how chronic endometritis and altered steroid receptor expression characterize endometrial changes in this endometriosis subgroup.
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