title: Time series analysis of transmesothelial invasion by endometrial stromal and epithelial cells using three-dimensional confocal microscopy.
abstract: OBJECTIVE
  To evaluate endometrial adhesion and invasion of peritoneal mesothelium.
  
  
  METHODS
  Descriptive study using confocal laser-scanning microscopy.
  
  
  METHODS
  University-based laboratory.
  
  
  METHODS
  Women undergoing surgery for benign conditions.
  
  
  METHODS
  Fluorescence-labeled peritoneal mesothelial cells (PMCs) were grown on coverslips. Fluorescence-labeled endometrial stromal cells (ESCs) and epithelial cells (EECs) and myometrial cells (Myos) were plated on the PMCs. Cultures were examined at 1, 6, 12, and 24-27 hours with differential interference contrast and confocal laser-scanning microscopy.
  
  
  METHODS
  Demonstration of adherence and invasion of endometrial cells through peritoneal mesothelium.
  
  
  RESULTS
  At 1 hour, there was adherence of the ESCs, EECs, and Myos on the perimeter of PMCs. There was no invasion by the Myos. By 6 hours, ESCs and EECs spread over the surface of the PMCs and extended cell processes through PMC junctions. Extension of pseudopodia under the PMCs followed. By 12 hours, there was vacuolization and lifting of PMCs that had been undermined by endometrial cells.
  
  
  CONCLUSIONS
  This is the first time-phase study to demonstrate adherence and the process of invasion of endometrial cells through the mesothelium. The application of three-dimensional confocal laser-scanning microscopy is a novel technique that can be used to further examine mechanisms involved in the pathogenesis of the early endometriotic lesion.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA. witz@uthscsa.edu
authors.forename: Craig A
authors.initials: CA
authors.lastname: Witz
authors.forename: Sook
authors.initials: S
authors.lastname: Cho
authors.forename: Victoria E
authors.initials: VE
authors.lastname: Centonze
authors.forename: Iris A
authors.initials: IA
authors.lastname: Montoya-Rodriguez
authors.forename: Robert S
authors.initials: RS
authors.lastname: Schenken
mesh_terms: D000328:Adult; D002448:Cell Adhesion / Q000502:physiology; D002465:Cell Movement / Q000502:physiology; D004715:Endometriosis / Q000473:pathology*; D004717:Endometrium / Q000166:cytology*; D004847:Epithelial Cells / Q000166:cytology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D018613:Microscopy, Confocal / Q000379:methods; D008857:Microscopy, Interference / Q000379:methods; D010537:Peritoneum / Q000166:cytology; D017154:Stromal Cells / Q000166:cytology; D013997:Time Factors