Detection of aromatase cytochrome P-450 in endometrial biopsy specimens as a diagnostic test for endometriosis.
OBJECTIVE
To evaluate the clinical usefulness of examining endometrial biopsy specimens for aromatase cytochrome P-450 as a diagnostic test for endometriosis.


METHODS
Retrospective, case-controlled study.


METHODS
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Kyoto, Japan.


METHODS
One hundred five women of reproductive age with normal menstrual cycles underwent endometrial biopsy laparotomy or laparoscopy, and examination of their tissue revealed endometriosis, adenomyosis, and/or leiomyomas. Patients who had cervical carcinoma in situ but no other gynecologic disease were considered to be disease-free.


METHODS
Endometrial biopsy specimens were collected.


METHODS
The expression of aromatase cytochrome P-450 was examined by reverse transcription-polymerase chain reaction and immunohistochemical analysis. The distribution and intensity of the immunostaining was assessed using a semiquantitative index designed H-score.


RESULTS
Immunostaining for aromatase cytochrome P-450 was detected in biopsy specimens obtained from patients with endometriosis, adenomyosis, and/or leiomyomas but not in specimens obtained from disease-free patients (H-score <20), with a sensitivity and specificity of 91% and 100%, respectively.


CONCLUSIONS
The expression of aromatase cytochrome P-450 in biopsy specimens of eutopic endometrium distinguishes between disease-free women and women with endometriosis, adenomyosis, and/or leiomyomas. This technique can be used at outpatient infertility clinics as an initial screening procedure to rule out the presence of estrogen-dependent disease.
Kitawaki
J
J
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Japan. kitawaki@koto.kpu-m.ac.jp
Kusuki
I
I
Koshiba
H
H
Tsukamoto
K
K
Fushiki
S
S
Honjo
H
H
D000328:Adult; D001141:Aromatase / Q000032:analysis*; D001706:Biopsy; D004715:Endometriosis / Q000175:diagnosis / Q000201:enzymology*; D004717:Endometrium / Q000201:enzymology* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies
D001141:Aromatase