[Correlation between laparoscopic aspects and glandular hystological findings of peritoneal endometriotic lesions].
OBJECTIVE
To evaluate the correlation between laparoscopic aspects and glandular hystological findings of peritoneal endometriosis to understand the theory of evolution of endometriosis.


METHODS
Sixty seven women with peritoneal endometriosis were submitted to laparoscopy. Peritoneal biopsy was taken from the typical (puckered black) and atypical endometriotic implants. The different aspects of endometriosis were classified as follows: red lesions (group V), black lesions (group N) and white lesions (group B). Hystological sections were examined according to a standardized protocol. The hystological parameters used were: functional characteristics of glandular epithelium, presence of intraluminal debris, occurrence of mitosis and stroma/gland ratio.


RESULTS
Functional characteristics of glandular epithelium showed statistically significant association among groups. Secretory epithelium was found in 68.4 % of group V, in 15.8% of groups N & B, while not characteristic epithelium was found in 19.4% of red lesions, 38.7% of black lesions and 41.9% of white lesions. Proliferative epithelium was found in 50% of group B patients and in 25% of groups V & N (p=0.011). Regarding intraluminal debris, there were also statistically significant differences among the groups, present in 58.4% of group N, 33.3% of group B and 8.3% of group V (p=0.016). There was no statistical difference between occurrence of mitosis (P=0.428), nor in the stroma/gland ratio (p=0.159).


CONCLUSIONS
Association between functional activity and red lesions and low activity in black and white lesions, regarding the hystological characteristics of the glandular epithelium analyzed in this study shows the importance of the theory of evolution of endometriosis. This was also demonstrated by presence of intraluminal debris in the study groups.
Viscomi
Francesco Antonio
FA
Instituto Vascomi, Ginecologia Minimamente Invasiva, São Paulo, SP. viscomi@terra.com.br
Dias
Rogério
R
De Luca
Laurival
L
Franco
Marcello Fabiano de
MF
Ihlenfeld
Mauro Fernando Kürten
MF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001706:Biopsy; D004715:Endometriosis / Q000145:classification / Q000473:pathology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D008940:Mitotic Index; D010298:Parity; D010532:Peritoneal Diseases / Q000473:pathology*; D010537:Peritoneum / Q000473:pathology*