Abstract
Objective
Endometriosis is commonly believed to originate from functionalis endometrium and
adenomyosis from basalis endometrium. Due to the lack of enough information, we investigated
the biological differences between these two layers of endometrium in women with and
without adenomyosis.
Study design
This was a case-controlled study with 12 control women and 17 women with adenomyosis
undergoing hysterectomy. Full thickness (extending from the endometrium to the myometrium)
biopsy specimens were obtained after the hysterectomy. Based on the phases of the
menstrual cycle, the expression patterns of estrogen receptor (ER), progesterone receptor
(PR), Ki-67, and activated Caspase-3 were analyzed by immunohistochemistry in the
functionalis and basalis endometria. Apoptotic cells were evaluated by TdT-mediated
dUTP-biotin nick end-labeling (TUNEL) assay.
Results
A similar pattern of ER and PR expression was found in the functionalis and basalis
endometria during the proliferative phase. In contrast, a significantly lower ER and
PR expression was found in the basalis endometria than in the functionalis endometria
during the secretory phase and the menstrual phase. This was equally observed in control
women and in women with adenomyosis. Except Ki-67 indices, TUNEL-positive cells, and
expression of activated Caspase-3 were significantly lower in the basalis endometria
than in the functionalis endometria during the secretory phase.
Conclusion
A significant biological difference was found between the functionalis and the basalis
endometria derived from women with adenomyosis.
Keywords
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Article info
Publication history
Published online: May 20, 2016
Accepted:
May 13,
2016
Received in revised form:
May 2,
2016
Received:
January 19,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
