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The Impact on Ovarian Reserve of Ovarian Cystectomy Versus Laser Vaporization in the Treatment of Ovarian Endometrioma: A Randomized Clinical Trial
S34
Abstracts / Journal of Minimally Invasive Gynecology 24 (2017) S1–S201
Measurements and Main Results: There was a significant decrease in the level of four lipids in the blood and peritoneal fluid of patients with endometriosis in comparison to the myoma group, i.e., phosphatidylcholine PC 36: 4, lysophosphatidylcholine LPC 16: 0, sphingomyelin SM 34: 1, phosphoethanolamine PE O-34: 1. Only the level of phosphoethanolamine PE O-20:0 was found increased in endometrioid tissues as well as in biological fluids of patients with endometriosis, thus indicating a possible diagnostic use of this particular lipid. The sensitivity of this method for plasma was 93%, specificity 95%; for peritoneal fluid sensitivity 90% and specificity 95%. Conclusion: This study confirms the involvement of specific phospholipids and sphingolipids in the pathophysiology of endometriosis, and opens new possibilities for noninvasive diagnosis of endometriosis. 84
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:31 PM – GROUP A
Design: Retrospective Chart Review. Setting: Residency-affiliated community hospital. Patients: All patients referred to pelvic pain clinic from 2015 to May 2016, with biopsy confirmed endometriosis. Intervention: Subjects with CPP were compared with subjects without CPP. Measurements and Main Results: Of the 64 total subjects, 31(48.40%) had Chronic Pelvic Pain (CPP) and 33 (51.6%) did not. CPP subjects were more likely to be obese, with 12/31(38.%) having BMI >30, compared to 3/33(9.1%) of non-CPP subjects (p = .007). CPP subjects underwent more previous surgical procedures (mean 1.5, SD 1.9) than non-CPP subjects (mean 0.44, SD 0.6; p = .002). 17/33 (51.5%) CPP subjects experienced pain persistance after endometriosis treatment vs 6/33 (18.1%) of non-CPP subjects (p = .049). Severity of endometriosis and number of lesions removed were not associated with CPP. Irritable Bowel Syndrome(IBS) was present in 12/31(38.7%) of CPP subjects compared to 5/33(15.1%) of non-CPP subjects (p = .047). Intersticial Cystitis(IC) was present in 8/31(25.8%) of CPP subjects compared to 2/33(6.1%) non-CPP subjects (p = .049). 15/31(48.4%) of subjects in the CPP group had IBS, IC of both, compared with 7/33(21.1%) of subjects in the non-CPP group (Odds Ratio 3.48, 95% CI 1.16–10.38).
Temporarily Blocking the Uterine Artery to Dig Out a Diffused Adenomyosis Lesion Treated Laparoscopically Yong L. Gynecology, Changzhou Maternal and Child Health Hospital, Changzhou, Jiangsu, China Study Objective: To show the tips and tricks of a simpler technique for temporary blocking of the uterine artery in laparoscopic resection of a diffuse adenomyosis lesion to make the procedure more efficient and reproducible. Design: This study is designed to be a step-by-step explanation of the technique using videos and pictures . Setting: Changzhou Maternal and Child Health Hospital, Changzhou, China. Patients: Three patients (age 39–42 years,) were diagnosed with diffuse adenomyosis with severe secondary dysmenorrhea willing to reserve the uterus and a poor response to medical management. Gynecologic examination revealed that the uteri sizes were 9 to 14 weeks. Transvaginal ultrasonography revealed that the lesions were 4 to 7 cm in size. Intervention: Laparoscopic resection of the diffuse adenomyosis lesion was conducted after temporary blocking of the uterine artery with a rubber belt. Measurements and Main Results: Many adenomyosis patients with severe dysmenorrhea and menometrorrhagia have a large lesion; thus, the operating time is longer. We made an incision of the broad ligament of the avascular area near the uterine artery and pulled the rubber pressure pulse ligation tightly through to temporarily block the uterine artery without vasopressin completely through the laparoscopic resection of the diffuse adenomyosis lesion. Intraoperative blood loss was only 120 to 230 mL. Mirena was placed in the uterus from the vagina immediately after surgery. At the 3–25 month follow-up, visual analog scale scores were obviously reduced, and the menstrual quantity and amenorrhea dramatically declined after the surgery. All patients had no recurrence and no Mirena loss as assessed by vaginal ultrasound and the visual analog scale. Estrogen was maintained at the normal level after 3 months. Conclusion: Using the rubber belt to temporarily block the uterine artery in laparoscopic resection of the diffuse adenomyosis lesion offers the possibility of the rubber belt being effective, safe, and reproducible. 85
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:42 PM – GROUP B
The Impact of Concurrent Chronic Pain Conditions on the Development of Chronic Pelvic Pain in Women with Endometriosis Wagner CA, Jijon AJ. Minimally Invasive Gynecologic Division, Mercy Hospital, St. Louis, Missouri Study Objective: Determine non-gynecologic conditions associated with Chronic Pelvic Pain (CPP) in women with endometriosis.
Fig. 1. Associated Pain Conditions.
Findings
Obesity n(%) # of prior surgeries mean(SD) pain remission after surgery n(%) IBS n(%) IC n(%)
CPP group (n:31)
non-CPP group (n:33)
p-value
12 (38.7%) 1.57 (1.9) 17(56.7%)
3 (9.1%) 0.44 (0.6) 6 (18.1%)
.007 .002 .049
12 (38.7%) 8 (25.8%)
5 (15.1%) 2 (6.1%)
.047 .049
Conclusion: Our findings suggest that factors in addition to endometriosis contribute to development of CPP. Women with endometriosis should be screened for CPP, and when present should also be screened for IBS and IC. When surgically evaluating CPP, cystoscopy should be considered as part of the evaluation for IC.
86
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:49 PM – GROUP B
The Impact on Ovarian Reserve of Ovarian Cystectomy Versus Laser Vaporization in the Treatment of Ovarian Endometrioma: A Randomized Clinical Trial Ottolina J,1 Posadzka E,2 Ferrari S,1 Tandoi I,1 Castellano LM,1 Komenda J,2 Jach R,2 Candiani M1. 1San Raffaele Scientific Institute, Milan, Italy; 2Jagiellonian University, Collegium Medicum, Krakow, Poland
Abstracts / Journal of Minimally Invasive Gynecology 24 (2017) S1–S201 Study Objective: To determine whether and to what extent the two surgical procedures for endometrioma, cystectomy and laser vaporization, affect ovarian reserve. Recently, cystectomy has been questioned as an ideal surgical approach because it may involve excessive removal of ovarian tissue and the loss of follicles; laser vaporization has been proposed as a promising method to preserve ovarian function. Design: Prospective, multicentric, randomized (1:1) clinical trial. Setting: San Raffaele Scientific Institute, Milan; Collegium Medicum, Krakow, Poland. Patients: 40 patients undergoing surgery for symptomatic endometriomas larger than 3 cm. Intervention: Patients were randomly assigned to undergo either cystectomy (Group 1) or laser vaporization (Group 2). Patients of Group 1 have undergone a standardized laparoscopic stripping technique; patients of Group 2 have undergone drainage of the cyst content and vaporization of the internal wall with CO2 laser (Lumenis, AcuPulse Laser). Before, at 1- and 3-month follow-up, patients underwent pelvic ultrasound to determine the antral follicle count (AFC) and blood sample to determine AMH. Measurements and Main Results: Age and the mean size of endometriomas were similar between the two groups (Group 1 = 30.1 years, Group 2 = 31.9 years, p = .901; Group 1 = 4.9 cm, Group 2 = 4.5 cm, p = .141). AFC at 3-month follow-up was significantly higher compared to baseline in Group 2 (from 9.6 to 16.1, p = .010); AFC of the operated ovary was also found to be significantly higher after treatment in Group 2 (from 4.1 to 8.1, p = .011). In Group 1, AFC at 3-month follow-up and the AFC of the operated ovary did not differ from baseline (p = .121, p = .248). AMH at 3-month followup was not different from baseline in either group. Conclusion: CO2 laser vaporization for endometrioma yields an higher functional ovarian tissue, as determined by higher AFC count and no change in AMH, in comparison with cystectomy. These are preliminary data of an ongoing study, and the results need to be confirmed on a larger sample.
87
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:56 PM – GROUP B
2D and 3D Sonographic Features of Deep Endometriosis after Laparoscopic Bowel Resection and Correlation with Symptoms Zupi E, Martire F, Morosetti G, Pietropolli A, Piccione E, Exacoustos C. Department of Biomedicine and Prevention Obstetrics and Gynecological Clinic, University of Tor Vergata, Rome, Italy Study Objective: To evaluate the presence or absence of residual posterior disease and adhesions by 2D and 3D transvaginal sonography in patients who underwent segmental bowel resection for Deep Infiltrating Endometriosis (DIE). Furthermore the presence of residual pelvic endometriosis, adhesions and adenomyosis were correlated to symptoms and infertility. Design: Retrospective study. Setting: University Hospital. Patients: 50 premenopausal women (mean age 37.4 ± 5.2 yrs) with bowel DIE who underwent segmental bowel resection. Intervention: All patients underwent an accurate 2D, 3D and power Doppler transvaginal examination and mapping of the pelvic disease before and after surgery. All patients are assessed for pelvic pain by visual analog scale (VAS). The sonographic features of adenomyosis, adhesions, presence of ovarian, peritoneal and deep endometriosis were evaluated. A previous published mapping system to evaluate pelvic endometriosis was always performed. Measurements and Main Results: At the TVS scan performed within 6 month after surgery we found 14 patients (28%) with residual DIE, 38 patients (76%) with adhesions in the posterior compartment, 32 patients (64%) with sonographic features of adenomyosis. No patients showed ovarian endometriosis. Out of 25 women desiring pregnancy, 21 (84%) showed severe dysmenorrhea (vas >5), 13 (52%) had dyspareunia (vas >5) and 19 patients underwent to ART.
S35
Conclusion: DIE is a chronic disease that is not completely eradicable. After surgery painful symptomatology could be correlated to residual posterior disease and mostly to adhesions and adenomyosis. However surgery, when indicated, allows an improvement in painful symptomatology and quality of life. The spontaneous pregnancy rate in our study is not improved by surgery. 88
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 1:03 PM – GROUP B
Immunohistochemical Characteristic of Stem Cells Markers in Foci of Nodular and Diffuse Adenomyosis Dzhamaludinova KM,1 Kozachenko IF,1 Shchegolev AI,1 Adamyan LV,1 Stepanian AA2. 1Department of Operative Gynecology, Federal Research Center for Obstetrics, Gynecology, and Perinatology Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation; 2 Academia of Women’s Health and Endoscopic Surgery, Atlanta, Georgia Study Objective: To study the features of the clinical course and expression of stem cell markers in ectopic and ectopic endometrium in patients with nodular and diffused adenomyosis. Design: Cross-sectional study. Setting: Federal Scientific Center of Obstetrics, Gynaecology and Perinatology, Moscow, Russia. Patients: Included are 150 women who underwent surgery between 2014 and 2016 for pre-operative diagnosis of adenomyosis, subsequently confirmed with histological examination. Intervention: Immunohistochemical study of expression of stem cell markers in nodular and diffuse adenomyosis cells and comparison with eutopic endometrium. Measurements and Main Results: Immunohistochemical analysis of endometrial tissue and adenomyosis showed that a positive reaction with Musashi-1 was observed in both nuclei and in the cytoplasm of glandular and stromal cells. The maximum values were found in the nuclei of epithelial cells, where they exceeded the analogous phase of secretion by 35%. The cytoplasmic level of expression of Musashi-1 in proliferating epithelium was 21.7% higher than the values of the secretion phase. For COX-2, a cytoplasmic reaction is characteristic. As a result of the quantitative analysis of the intensity of the reaction on COX-2, it was established that in the tissue of normal endometrium the highest level of expression was observed in epithelial cells during the proliferation phase. Positive immunohistochemical reaction with OCT4 was observed in the nuclei of epithelial and stromal cells. In the observations of nodular adenomyosis, such OCT4+ epithelial and stromal cells were more by 67.7% and 41.3%, respectively, than in the eutopic endometrium of the proliferation phase. In areas of diffuse adenomyosis, their number exceeded the same parameters by 123.2% and 90.4%, respectively (p < .05). Conclusion: Aberrant Musashi-1 expression of stem cells markers in adenomyosis may be involved in the pathogenesis and pathophysiology of adenomyosis.
TUESDAY, NOVEMBER 14, 2017
89
Open Communications 5 – Research & Science (2:15 PM–3:15 PM) 2:15 PM – GROUP A
CXCR4 Mediated to Epithelial-Mesenchymal Transition and Stemness in Epithelial Ovarian Carcinoma Zi D,1 Tan J,2 Shu L,3 He Z,3 Jin H4. 1Department of Obstetrics and Gynecology, Gui Zhou Medical Unversity, Gui Yang, Gui Zhou, China;
Abstracts / Journal of Minimally Invasive Gynecology 24 (2017) S1–S201
Measurements and Main Results: There was a significant decrease in the level of four lipids in the blood and peritoneal fluid of patients with endometriosis in comparison to the myoma group, i.e., phosphatidylcholine PC 36: 4, lysophosphatidylcholine LPC 16: 0, sphingomyelin SM 34: 1, phosphoethanolamine PE O-34: 1. Only the level of phosphoethanolamine PE O-20:0 was found increased in endometrioid tissues as well as in biological fluids of patients with endometriosis, thus indicating a possible diagnostic use of this particular lipid. The sensitivity of this method for plasma was 93%, specificity 95%; for peritoneal fluid sensitivity 90% and specificity 95%. Conclusion: This study confirms the involvement of specific phospholipids and sphingolipids in the pathophysiology of endometriosis, and opens new possibilities for noninvasive diagnosis of endometriosis. 84
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:31 PM – GROUP A
Design: Retrospective Chart Review. Setting: Residency-affiliated community hospital. Patients: All patients referred to pelvic pain clinic from 2015 to May 2016, with biopsy confirmed endometriosis. Intervention: Subjects with CPP were compared with subjects without CPP. Measurements and Main Results: Of the 64 total subjects, 31(48.40%) had Chronic Pelvic Pain (CPP) and 33 (51.6%) did not. CPP subjects were more likely to be obese, with 12/31(38.%) having BMI >30, compared to 3/33(9.1%) of non-CPP subjects (p = .007). CPP subjects underwent more previous surgical procedures (mean 1.5, SD 1.9) than non-CPP subjects (mean 0.44, SD 0.6; p = .002). 17/33 (51.5%) CPP subjects experienced pain persistance after endometriosis treatment vs 6/33 (18.1%) of non-CPP subjects (p = .049). Severity of endometriosis and number of lesions removed were not associated with CPP. Irritable Bowel Syndrome(IBS) was present in 12/31(38.7%) of CPP subjects compared to 5/33(15.1%) of non-CPP subjects (p = .047). Intersticial Cystitis(IC) was present in 8/31(25.8%) of CPP subjects compared to 2/33(6.1%) non-CPP subjects (p = .049). 15/31(48.4%) of subjects in the CPP group had IBS, IC of both, compared with 7/33(21.1%) of subjects in the non-CPP group (Odds Ratio 3.48, 95% CI 1.16–10.38).
Temporarily Blocking the Uterine Artery to Dig Out a Diffused Adenomyosis Lesion Treated Laparoscopically Yong L. Gynecology, Changzhou Maternal and Child Health Hospital, Changzhou, Jiangsu, China Study Objective: To show the tips and tricks of a simpler technique for temporary blocking of the uterine artery in laparoscopic resection of a diffuse adenomyosis lesion to make the procedure more efficient and reproducible. Design: This study is designed to be a step-by-step explanation of the technique using videos and pictures . Setting: Changzhou Maternal and Child Health Hospital, Changzhou, China. Patients: Three patients (age 39–42 years,) were diagnosed with diffuse adenomyosis with severe secondary dysmenorrhea willing to reserve the uterus and a poor response to medical management. Gynecologic examination revealed that the uteri sizes were 9 to 14 weeks. Transvaginal ultrasonography revealed that the lesions were 4 to 7 cm in size. Intervention: Laparoscopic resection of the diffuse adenomyosis lesion was conducted after temporary blocking of the uterine artery with a rubber belt. Measurements and Main Results: Many adenomyosis patients with severe dysmenorrhea and menometrorrhagia have a large lesion; thus, the operating time is longer. We made an incision of the broad ligament of the avascular area near the uterine artery and pulled the rubber pressure pulse ligation tightly through to temporarily block the uterine artery without vasopressin completely through the laparoscopic resection of the diffuse adenomyosis lesion. Intraoperative blood loss was only 120 to 230 mL. Mirena was placed in the uterus from the vagina immediately after surgery. At the 3–25 month follow-up, visual analog scale scores were obviously reduced, and the menstrual quantity and amenorrhea dramatically declined after the surgery. All patients had no recurrence and no Mirena loss as assessed by vaginal ultrasound and the visual analog scale. Estrogen was maintained at the normal level after 3 months. Conclusion: Using the rubber belt to temporarily block the uterine artery in laparoscopic resection of the diffuse adenomyosis lesion offers the possibility of the rubber belt being effective, safe, and reproducible. 85
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:42 PM – GROUP B
The Impact of Concurrent Chronic Pain Conditions on the Development of Chronic Pelvic Pain in Women with Endometriosis Wagner CA, Jijon AJ. Minimally Invasive Gynecologic Division, Mercy Hospital, St. Louis, Missouri Study Objective: Determine non-gynecologic conditions associated with Chronic Pelvic Pain (CPP) in women with endometriosis.
Fig. 1. Associated Pain Conditions.
Findings
Obesity n(%) # of prior surgeries mean(SD) pain remission after surgery n(%) IBS n(%) IC n(%)
CPP group (n:31)
non-CPP group (n:33)
p-value
12 (38.7%) 1.57 (1.9) 17(56.7%)
3 (9.1%) 0.44 (0.6) 6 (18.1%)
.007 .002 .049
12 (38.7%) 8 (25.8%)
5 (15.1%) 2 (6.1%)
.047 .049
Conclusion: Our findings suggest that factors in addition to endometriosis contribute to development of CPP. Women with endometriosis should be screened for CPP, and when present should also be screened for IBS and IC. When surgically evaluating CPP, cystoscopy should be considered as part of the evaluation for IC.
86
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:49 PM – GROUP B
The Impact on Ovarian Reserve of Ovarian Cystectomy Versus Laser Vaporization in the Treatment of Ovarian Endometrioma: A Randomized Clinical Trial Ottolina J,1 Posadzka E,2 Ferrari S,1 Tandoi I,1 Castellano LM,1 Komenda J,2 Jach R,2 Candiani M1. 1San Raffaele Scientific Institute, Milan, Italy; 2Jagiellonian University, Collegium Medicum, Krakow, Poland
Abstracts / Journal of Minimally Invasive Gynecology 24 (2017) S1–S201 Study Objective: To determine whether and to what extent the two surgical procedures for endometrioma, cystectomy and laser vaporization, affect ovarian reserve. Recently, cystectomy has been questioned as an ideal surgical approach because it may involve excessive removal of ovarian tissue and the loss of follicles; laser vaporization has been proposed as a promising method to preserve ovarian function. Design: Prospective, multicentric, randomized (1:1) clinical trial. Setting: San Raffaele Scientific Institute, Milan; Collegium Medicum, Krakow, Poland. Patients: 40 patients undergoing surgery for symptomatic endometriomas larger than 3 cm. Intervention: Patients were randomly assigned to undergo either cystectomy (Group 1) or laser vaporization (Group 2). Patients of Group 1 have undergone a standardized laparoscopic stripping technique; patients of Group 2 have undergone drainage of the cyst content and vaporization of the internal wall with CO2 laser (Lumenis, AcuPulse Laser). Before, at 1- and 3-month follow-up, patients underwent pelvic ultrasound to determine the antral follicle count (AFC) and blood sample to determine AMH. Measurements and Main Results: Age and the mean size of endometriomas were similar between the two groups (Group 1 = 30.1 years, Group 2 = 31.9 years, p = .901; Group 1 = 4.9 cm, Group 2 = 4.5 cm, p = .141). AFC at 3-month follow-up was significantly higher compared to baseline in Group 2 (from 9.6 to 16.1, p = .010); AFC of the operated ovary was also found to be significantly higher after treatment in Group 2 (from 4.1 to 8.1, p = .011). In Group 1, AFC at 3-month follow-up and the AFC of the operated ovary did not differ from baseline (p = .121, p = .248). AMH at 3-month followup was not different from baseline in either group. Conclusion: CO2 laser vaporization for endometrioma yields an higher functional ovarian tissue, as determined by higher AFC count and no change in AMH, in comparison with cystectomy. These are preliminary data of an ongoing study, and the results need to be confirmed on a larger sample.
87
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 12:56 PM – GROUP B
2D and 3D Sonographic Features of Deep Endometriosis after Laparoscopic Bowel Resection and Correlation with Symptoms Zupi E, Martire F, Morosetti G, Pietropolli A, Piccione E, Exacoustos C. Department of Biomedicine and Prevention Obstetrics and Gynecological Clinic, University of Tor Vergata, Rome, Italy Study Objective: To evaluate the presence or absence of residual posterior disease and adhesions by 2D and 3D transvaginal sonography in patients who underwent segmental bowel resection for Deep Infiltrating Endometriosis (DIE). Furthermore the presence of residual pelvic endometriosis, adhesions and adenomyosis were correlated to symptoms and infertility. Design: Retrospective study. Setting: University Hospital. Patients: 50 premenopausal women (mean age 37.4 ± 5.2 yrs) with bowel DIE who underwent segmental bowel resection. Intervention: All patients underwent an accurate 2D, 3D and power Doppler transvaginal examination and mapping of the pelvic disease before and after surgery. All patients are assessed for pelvic pain by visual analog scale (VAS). The sonographic features of adenomyosis, adhesions, presence of ovarian, peritoneal and deep endometriosis were evaluated. A previous published mapping system to evaluate pelvic endometriosis was always performed. Measurements and Main Results: At the TVS scan performed within 6 month after surgery we found 14 patients (28%) with residual DIE, 38 patients (76%) with adhesions in the posterior compartment, 32 patients (64%) with sonographic features of adenomyosis. No patients showed ovarian endometriosis. Out of 25 women desiring pregnancy, 21 (84%) showed severe dysmenorrhea (vas >5), 13 (52%) had dyspareunia (vas >5) and 19 patients underwent to ART.
S35
Conclusion: DIE is a chronic disease that is not completely eradicable. After surgery painful symptomatology could be correlated to residual posterior disease and mostly to adhesions and adenomyosis. However surgery, when indicated, allows an improvement in painful symptomatology and quality of life. The spontaneous pregnancy rate in our study is not improved by surgery. 88
Open Communications 4 – Endometriosis and Adenomyosis (12:10 PM–1:10 PM) 1:03 PM – GROUP B
Immunohistochemical Characteristic of Stem Cells Markers in Foci of Nodular and Diffuse Adenomyosis Dzhamaludinova KM,1 Kozachenko IF,1 Shchegolev AI,1 Adamyan LV,1 Stepanian AA2. 1Department of Operative Gynecology, Federal Research Center for Obstetrics, Gynecology, and Perinatology Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation; 2 Academia of Women’s Health and Endoscopic Surgery, Atlanta, Georgia Study Objective: To study the features of the clinical course and expression of stem cell markers in ectopic and ectopic endometrium in patients with nodular and diffused adenomyosis. Design: Cross-sectional study. Setting: Federal Scientific Center of Obstetrics, Gynaecology and Perinatology, Moscow, Russia. Patients: Included are 150 women who underwent surgery between 2014 and 2016 for pre-operative diagnosis of adenomyosis, subsequently confirmed with histological examination. Intervention: Immunohistochemical study of expression of stem cell markers in nodular and diffuse adenomyosis cells and comparison with eutopic endometrium. Measurements and Main Results: Immunohistochemical analysis of endometrial tissue and adenomyosis showed that a positive reaction with Musashi-1 was observed in both nuclei and in the cytoplasm of glandular and stromal cells. The maximum values were found in the nuclei of epithelial cells, where they exceeded the analogous phase of secretion by 35%. The cytoplasmic level of expression of Musashi-1 in proliferating epithelium was 21.7% higher than the values of the secretion phase. For COX-2, a cytoplasmic reaction is characteristic. As a result of the quantitative analysis of the intensity of the reaction on COX-2, it was established that in the tissue of normal endometrium the highest level of expression was observed in epithelial cells during the proliferation phase. Positive immunohistochemical reaction with OCT4 was observed in the nuclei of epithelial and stromal cells. In the observations of nodular adenomyosis, such OCT4+ epithelial and stromal cells were more by 67.7% and 41.3%, respectively, than in the eutopic endometrium of the proliferation phase. In areas of diffuse adenomyosis, their number exceeded the same parameters by 123.2% and 90.4%, respectively (p < .05). Conclusion: Aberrant Musashi-1 expression of stem cells markers in adenomyosis may be involved in the pathogenesis and pathophysiology of adenomyosis.
TUESDAY, NOVEMBER 14, 2017
89
Open Communications 5 – Research & Science (2:15 PM–3:15 PM) 2:15 PM – GROUP A
CXCR4 Mediated to Epithelial-Mesenchymal Transition and Stemness in Epithelial Ovarian Carcinoma Zi D,1 Tan J,2 Shu L,3 He Z,3 Jin H4. 1Department of Obstetrics and Gynecology, Gui Zhou Medical Unversity, Gui Yang, Gui Zhou, China;