Correlation between Anatomopathological Aspects and Pelvic Pain in Women with Deep Infiltrating Endometriosis

Abstract

Objective To correlate the morphological aspects with pelvic pain in women with deep infiltrating endometriosis.

Methods A retrospective study with 67 women with deep endometriosis who underwent surgical treatment in a tertiary hospital from 2007 to 2017. The following variables were considered: age, parity, body mass index, site of involvement, hormonal treatment before surgery, pelvic pain, and morphometric analysis. The histological slides of the surgical specimens were revised and, using the ImageJ software for morphometric study, the percentages of stromal/glandular tissues were calculated in the histological sections.

Results The mean age of the women was 38.9 ± 6.5 years. The mean pain score was 8.8 ± 1.9 and the mean time of symptomatology was 4.7 ± 3.5 years, with 87% of the patients undergoing hormone treatment prior to surgery. The average expression of CD10, CK7, and S100 markers was 19.5 ± 11.8%, 9.4 ± 5.9%, and 7.9 ± 5.8% respectively. It was found that the greater the expression of CD10, the greater the level of pain (p = 0.02). No correlation was observed between the expression of CD10, CK7, and S100 markers and age and duration of symptoms.

Conclusion Women with deep infiltrating endometriosis have a positive association between the level of pain and the fibrosis component in the endometrial tissue's histological composition.

Resumo

Objetivo Correlacionar os aspectos morfológicos com a dor pélvica em mulheres com endometriose profunda.

Métodos Estudo retrospectivo com 67 mulheres com endometriose profunda submetidas a tratamento cirúrgico em hospital terciário de 2007 a 2017. As seguintes variáveis foram consideradas: idade, paridade, índice de massa corporal, local do acometimento, tratamento hormonal antes da cirurgia, dor pélvica e análise morfométrica. As lâminas histológicas das peças cirúrgicas foram revisadas e, por meio do software ImageJ para estudo morfométrico, foram calculadas as porcentagens de tecidos estromais/glandulares nos cortes histológicos.

Resultados A média etária das mulheres foi de 38,9 ± 6,5 anos. O escore de dor médio foi de 8,8 ± 1,9 e o tempo médio de sintomatologia foi de 4,7 ± 3,5 anos, sendo que 87% das pacientes realizavam tratamento hormonal antes da cirurgia. A expressão média dos marcadores CD10, CK7 e S100 foi de 19,5 ± 11,8%, 9,4 ± 5,9% e 7,9 ± 5,8%, respectivamente. Verificou-se que quanto maior a expressão de CD10, maior o nível de dor (p = 0,02). Não foi observada correlação entre a expressão dos marcadores CD10, CK7 e S100 com a idade e duração dos sintomas.

Conclusão Mulheres com endometriose profunda apresentam associação positiva entre o nível de dor e o componente de fibrose na composição histológica do tecido endometrial.

Keywords

Deep infiltrating endometriosis - Histology - Pain

Palavras-chave

Endometriose profunda - Histologia - Dor

Contributions

All the authors participated actively in the study, as follows: DA Yela conceptualized and designed the study, she also wrote and reviewed the manuscript. She was also involved in the interpretation of results. MSS Silva conceptualized and designed the study and helped in the acquisition of data, interpretation of results, and writing the manuscript. L Eloy was responsible for the anatomopathological analyzes. CL Benetti-Pinto reviewed the manuscript.

Publication History

Received: 24 April 2023

Accepted: 16 June 2023

Article published online:
23 December 2023

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