Cesarean Section Scar Endometriomas: Immunohistochemical Staining of Estrogen Receptor-alpha, and CD34 | ||||
| The Egyptian Journal of Fertility of Sterility | ||||
| Article 4, Volume 17, Issue 1 - Serial Number 11106352, January 2013, Page 16-19 PDF (1.6 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2013.257466 | ||||
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| Author | ||||
Abdelaziz A. Elrefaeey, Anas M. Gama, Iman Yassein, Khaled R. Zalata  1, 2
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| 11Department of Obstetrics and Gynecology | ||||
| 22Department of Pathology, Faculty of Medicine, Mansoura University, Egypt | ||||
| Abstract | ||||
| Objective: Cesarean section scar endometriomas (CSSEs) are believed to be the result of direct inoculation of the subcutaneous tissues or abdominal fascia with endometrial cells during surgery as well as higher immune tolerance during pregnancy. The ectopic endometrium exhibits multiple subtle, but biologically important, molecular abnormalities favoring increased production of estrogen, cytokines, prostaglandins, and metalloproteinases. Patients and Methods: The present study was undertaken to immunohistochemically study the expression of the nuclear estrogen receptors (ERs) alpha and cytoplasmic endothelial cell markers CD34 in 34 cases of CSSEs, 27 cases of ovarian endometriomas (OEs) compared with 18 cases with late proliferative endometrium (PE) as control group < br />Results: The incidence of CSSEs is 0.39% in Mansoura university hospitals, the mean total score (TS) of ERs-alpha and CD34 assessed by mean vascular density (CD-34 MVD) were significantly increased (p < 0.001) in cases of CSSEs and OEs versus the control group. There was a statistically significant increase in the TS of ERs-alpha (p < 0.001) in cases of OEs versus CSSEs. On the other hand, there was no statistically significant difference in CD-34 MVD between cases of CSSEs and OVs. In cases with CSSEs, there was no significant correlation (r 0.212, p 0.229) between TS of ERs-alpha and CD-34 MVD. No significant correlations were noted between either ERs or CD-34 MVD and age of the patients, parity, number of prior CSs, duration since the last CS(s) and size of CSSEs. Conclusion: CSSEs are a multifactorial disease, both ERs alpha and CD34 may play a role in the pathogenesis and maintenance of endometriosis. Obstetricians should keep in mind measures to prevent transmission of endometrial cells during CS. | ||||
| Keywords | ||||
| Key words: Cesarean section scar endometriomas; ovarian endometriomas; immunohistochemical staining; CD34; ERs-alpha | ||||
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