Investigation of c nerve fibres in the endometrium of patients diagnosed with endometriosis, endometrioma or adenomyosis

ABSTRACTINVESTIGATION OF C NERVE FIBRES IN THE ENDOMETRIUM OF PATIENTS DIAGNOSED WITH ENDOMETRIOSIS, ENDOMETRIOMA OR ADENOMYOSISThe gold standard in the diagnosis of endometriosis is laparoscopy. In the present study, endometrial biopsy, a less invasive method compared to laparoscopy, was performed and C nerve fibres ratio was investigated in those endometrial samples in order to investigate the utility of this technique in the diagnosis of endometriosis. C nerve fibres ratio was compared among endometriosis, endometrioma, adenomyosis and control groups and the role of endometrial biopsy in the diagnosis of those pathological conditions was sought.The present study was comprised of 20 patients with endometriosis, 20 patients with endometrioma, 20 patients with adenomyosis and 20 patients without those pathologies as the control group. Endometrial biopsy was performed during the operation in all the patients included. Endometrial samples were treated with both S-100 and PGP9.5 immunohistochemical dyes in order to determine nerve fibres. The results were analyzed statistically with Kruskal Wallis and Mann Whitney U tests.The ratio of C nerve fibres in the endometriosis, endometrioma and adenomyosis groups were found to be significantly higher than the control group. Among the groups, the ratio of C nerve fibres was found to be significantly higher in the endometrioma and adenomyosis groups compared to the endometriosis group. In all the three groups with pathologies, C nerve fibres ratio was evaluated according to the presence of dysmenorrhea/dyspareunia and, significantly higher ratio was observed in those with dysmenorrhea/dyspareunia. As regards the endometriosis stage, no significant difference was found in C nerve fibres ratio.In conclusion, significantly higher ratio of C nerve fibers found in the endometriosis, endometrioma and adenomyosis groups compared to the control group suggests that endometrial biopsy might be a simple and reliable method to be used in the diagnosis of endometriosis.Key words: Adenomyosis, Endometriosis, Endometrioma, Endometrial Biopsy, Immunohistochemistry, Nerve Fibres