title: Immunohistochemical evaluation of epithelial antigen Ber-Ep4 and CD10: new markers for endometriosis?
abstract: BACKGROUND
  Early and certain diagnoses of endometriosis are mandatory to begin the correct treatment and to exclude the risk of endometriosis-associated ovarian carcinoma (EOC) and endometrial stromal sarcoma (ESS).
  
  
  OBJECTIVE
  To assess the immunohistochemical expression of Ber-Ep4, an epithelial antigen, and CD10 in endometriosis.
  
  
  METHODS
  Forty-eight women underwent laparoscopic surgery for endometriosis and endometriotic samples were recovered for histology. In all surgical specimens Ber-Ep4 and CD10 were searched by an immnohistochemical method. The authors evaluated the correlations among the immunohistochemical positivity and the location of endometriosis.
  
  
  RESULTS
  Most cases (40/48 83.34%) were represented by ovarian endometriotic cyst. Among the eight remaining cases, three (3/48, 6.25%) were pelvic endometriotic lesions, two (2/48, 4.17%) peritoneum of vesico-uterine pouch, one vaginal lesion (2.08%), one salpinx lesion (2.08%), and one inguinal location (2.08%). Ber-Ep4 and CD10 were expressed in 90% and in 100% of the ovarian lesions, respectively. In pelvic lesions Ber-Ep4 and CD10 showed both 66.67% of positivity and had the same pattern in peritoneal, salpinx, vaginal, and inguinal lesions (50%, 100%, 100%, 100%, respectively). Ber-Ep4 was negative in 6/48 (12.5%) cases whereas CDO10 was negative in 2/48 (4.17%) cases of endometriosis. The sensitivity of Ber-Ep4 and CD10 for endometriosis diagnosis were 87.50% and 95.83%, respectively. Immunohistochemistry for Ber-Ep4 showed positivity in all cases of endometriosis with typical cubic epithelium, whereas CD10 was positive in 1/2 (50%) atypical case.
  
  
  CONCLUSIONS
  Immunohistochemical expression of Ber-Ep4 and CD10 was positive in most cases of endometriosis and was useful in differential diagnosis with mesothelial cysts. Ber-Ep4 was negative in cases of hyperplastic epithelium or cytological atypia; these cases are not well-differentiated and could be optimally treated by surgery and not by hormonal therapy because of the risk of cancer degeneration.
authors: Gynaecologic and Obstetric Clinic, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy
authors: G
authors: G
authors: Capobianco
authors: J M
authors: JM
authors: Wenger
authors: V
authors: V
authors: Marras
authors: E
authors: E
authors: Cosmi
authors: G
authors: G
authors: Ambrosini
authors: M
authors: M
authors: Dessole
authors: P L
authors: PL
authors: Cherchi
mesh_terms: D000328:Adult; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000032:analysis*; D004715:Endometriosis / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D015260:Neprilysin / Q000032:analysis*; D000951:Antigens, Neoplasm
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D015260:Neprilysin; C115012:human epithelial antigen-125; D000951:Antigens, Neoplasm