aromatase expression in endometriotic tissues and its relationship

7/25/2019 Aromatase Expression in Endometriotic Tissues and Its Relationship

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Aromatase expression in endometriotic tissues

and its relationship to clinical

and analytical findings

Podro Acien M. D , Irene Velasco, B.Sc., PhD.,

Mercedes Gutierrez, M. D and M. M. Beltran, M.D.

Fertility and Sterility Vol. 88 No. 1, July 2!


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"N#$%&'(#"%N

)tiology of endometriosis is not *ell

esta+lished.

Aromatase expression is a+sent in eutopic

endometrium and aromatase is not expressedin the endometrium of diseasefree *omen.

Aromatase expression in stromal cells of

endometriosis may promote the gro*th ofendometriotic implants +ecause of the

hormonedependent character of the disease.


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%-J)(#"V)

#o study the relationship +et*een

aromatase expression in endometrotic

tissues and clinical and la+oratory

findings.


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aterial / method

)N&%)#$"%S"S 0$%'

2 *omen *ho had regular

o3ulatory cycles

and *ho *ere going to ha3e 4

laparoscopylaparotomy 5conser3ati3e

surgery6hysterectomy and

salpingooophorectomy,+ecause of recurrent and

se3ere endometriosis.

N%N )N&%)#$"%S"S 0$%'

12 *omen *ho had

sho*n a clinical or

echographic differentialdiagnosis *ith endometriomas,

*ho had undergone surgery for

dermoid cystt or other

nonfunctioning o3arian tumor

7ad not recei3ed any pre3ious medical or surgical treatment

of endometriosis at least months +efore surgery


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)ndometriosis group Non )ndometriosis

A repeated #VS 'S0

VAS for endometriosis 5dysmenorrhea, dyspaurenia,( / others6

9a+oratory test 5sedimentation rate,(A12:,(A1;;,)2,,$9,"g0,"gA,"g

Surgery < classification criteria of the AS$

=; pts conser3ati3e surgery / 1 pts 7#-S%

Study aromatase expression

Symptomps of the disease, ultrasound and surgical findings, 3alues of

tumor mar>ers, steroids and immunoglo+ulins and recurence after surgery

Follo* up for 1 year


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$)S'9#S

Aromatase *as locali?ed in the stroma and not

in the epithelium of lesions.

Aromatase *as a+sent from nonendometriosis patient.


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$)S'9#S

ositi3e aromatase expression in

endometriotic tissues from 8 *omen 51,@6.

Nine of them *as only o+ser3ed in

endometrioma from one o3ary, despite+ilateral o3arian endometriomas.

1 cases had peritoneal implants and deeplesions. of them expressed aromatase.


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$)S'9#S


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$)S'9#S


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&"S('SS"%N

Aromatase *as detected in ,2@ of cases,

*hich could present more se3ere

endometriosis, *ith higher 3alues of (a12:.

Aromatase *as negati3e in the rest of thetissue studied and in the 12 cases *ithout

endometriosis.

Not o+ser3e mar>ed differences +ecause of

the lo* num+er of cases.


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&"S('SS"%N

Aromatasepositi3e patients had more

endometriomas, freuently +ilateral, and more

moderate to se3ere (. And seemed to +e

related to the presence of infertility orassociated leiomyomas, +ut not to recurrence.

)2 and $9 le3els *ere significantly higher

and "g0 le3els *ere lo*er, than in aromatase

B negati3e patients.


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&"S('SS"%N

"nfertility and asociated leiomyomas *ere

more freuent in aromatase expression,

though *ithout significant differences.

No differences in recurrence of the disease 1year later.

7igh 3alues of +lood sedimentation rate *ere

not freuent in aromatasenegati3e patients.


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(%N(9'S"%N

Aromatase in endometriotic tissues could +e

in3ol3ed in the de3elopment or maintenance of

endometriosis, and relate *ith maCor se3erity,

acti3ity and (.


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($"#"(A9 A$A"SA9

Das a defined, representati3e sample of

patients assem+led as a common point in the

course of their disease E

#he sample is not representati3e +ecause itCust a lo* num+er of cases.

#hey *ere recruited +efore surgery.


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($"#"(A9 A$A"SA9

Das patients follo*up sufficiently long and

complete E

es.

#hey *ere scheduled for follo* up e3ery months 1 year for recurrences 51 year6.


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($"#"(A9 A$A"SA9

Dere o+Cecti3e outcome criteria applied in a

G+lindH fashion

No.

-ut study factor and outcomes *ere measuredin many *ays using se3eral standarised and

3alidates forms.


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($"#"(A9 A$A"SA9

Dere o+Cecti3e outcome criteria applied in a

G+lindH fashion

No.

-ut study factor and outcomes *ere measuredin many *ays using se3eral standarised and

3alidates forms.


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($"#"(A9 A$A"SA9

"f su+groups *ith different prognoses are

identified, *as there adCustment for important

prognostic factors E

$epeated measure analyses factored indifferences in +aseline characteristics.

"f su+groups *ith different prognoses are

identified, *as there 3alidation in an

independent group 5Gtest setH6 of patients E

es.


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($"#"(A9 A$A"SA9

7o* li>ely are the outcomes o3er time E

&ata *ere not presented this *ay.

De donIt >no* ho* long the patients

diagnosed *ithendometriosis +efore surgery.

7o* precise are the prognostic estimates E

No confidence inter3als pro3ided.


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($"#"(A9 A$A"SA9

Dere the study patients similar to your o*n E

es.

Dill this e3idence ma>e a clinically important

impact on your conclusionc a+out *hat to offer

or tell your patient E

es. -ut itIs too expensi3e to analy?e theexpression of aromatase for patients *ith

endometriosis.


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#han> you

aromatase expression in endometriotic tissues and its relationship

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