Abstract
While endometrial neutrophils and plasma cells are criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease (PID) research, plasma cell misidentification and nonspecificity may limit the accuracy of these criteria. Herein, we examined: (1) the identification of endometrial plasma cells with conventional methyl green pyronin-based methodology versus plasma cell-specific (CD138) immunostaining, (2) the prevalence of endometrial plasma cells among women at low risk for PID, and (3) endometrial leukocyte subpopulations among women diagnosed with acute or chronic histologic endometritis by conventional criteria. We observed an absence of CD138+ cells in 25% of endometrial biopsies in which plasma cells had been identified by conventional methodology, while additional immunohistochemical analyses revealed indistinguishable inflammatory infiltrates among women diagnosed with acute or chronic endometritis by conventional criteria. Among women considered at lower risk for PID development, flow cytometric analyses detected plasma cells in 30% of endometrial biopsy specimens, suggesting that these cells, even when accurately identified, only nonspecifically identify upper genital tract inflammatory processes. Combined, our findings underscore the limitations of the criteria used to diagnose histologic endometritis in PID-related research and suggest that satisfactory understanding of PID pathogenesis, treatment, and prevention is hindered by continued use of these criteria.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 680-685 |
| Number of pages | 6 |
| Journal | Pathology Research and Practice |
| Volume | 207 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 15 2011 |
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Keywords
- Histologic endometritis
- Pelvic inflammatory disease
- Plasma cell
- Syndecan-1
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Cell Biology
Cite this
Limitations of the criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease research. / Miguel, Rodolfo D Vicetti; Chivukula, Mamatha; Krishnamurti, Uma; Amortegui, Antonio J.; Kant, Jeffrey A.; Sweet, Richard L; Wiesenfeld, Harold C.; Phillips, Jaclyn M.; Cherpes, Thomas L.
In: Pathology Research and Practice, Vol. 207, No. 11, 15.11.2011, p. 680-685.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Limitations of the criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease research
AU - Miguel, Rodolfo D Vicetti
AU - Chivukula, Mamatha
AU - Krishnamurti, Uma
AU - Amortegui, Antonio J.
AU - Kant, Jeffrey A.
AU - Sweet, Richard L
AU - Wiesenfeld, Harold C.
AU - Phillips, Jaclyn M.
AU - Cherpes, Thomas L.
PY - 2011/11/15
Y1 - 2011/11/15
N2 - While endometrial neutrophils and plasma cells are criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease (PID) research, plasma cell misidentification and nonspecificity may limit the accuracy of these criteria. Herein, we examined: (1) the identification of endometrial plasma cells with conventional methyl green pyronin-based methodology versus plasma cell-specific (CD138) immunostaining, (2) the prevalence of endometrial plasma cells among women at low risk for PID, and (3) endometrial leukocyte subpopulations among women diagnosed with acute or chronic histologic endometritis by conventional criteria. We observed an absence of CD138+ cells in 25% of endometrial biopsies in which plasma cells had been identified by conventional methodology, while additional immunohistochemical analyses revealed indistinguishable inflammatory infiltrates among women diagnosed with acute or chronic endometritis by conventional criteria. Among women considered at lower risk for PID development, flow cytometric analyses detected plasma cells in 30% of endometrial biopsy specimens, suggesting that these cells, even when accurately identified, only nonspecifically identify upper genital tract inflammatory processes. Combined, our findings underscore the limitations of the criteria used to diagnose histologic endometritis in PID-related research and suggest that satisfactory understanding of PID pathogenesis, treatment, and prevention is hindered by continued use of these criteria.
AB - While endometrial neutrophils and plasma cells are criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease (PID) research, plasma cell misidentification and nonspecificity may limit the accuracy of these criteria. Herein, we examined: (1) the identification of endometrial plasma cells with conventional methyl green pyronin-based methodology versus plasma cell-specific (CD138) immunostaining, (2) the prevalence of endometrial plasma cells among women at low risk for PID, and (3) endometrial leukocyte subpopulations among women diagnosed with acute or chronic histologic endometritis by conventional criteria. We observed an absence of CD138+ cells in 25% of endometrial biopsies in which plasma cells had been identified by conventional methodology, while additional immunohistochemical analyses revealed indistinguishable inflammatory infiltrates among women diagnosed with acute or chronic endometritis by conventional criteria. Among women considered at lower risk for PID development, flow cytometric analyses detected plasma cells in 30% of endometrial biopsy specimens, suggesting that these cells, even when accurately identified, only nonspecifically identify upper genital tract inflammatory processes. Combined, our findings underscore the limitations of the criteria used to diagnose histologic endometritis in PID-related research and suggest that satisfactory understanding of PID pathogenesis, treatment, and prevention is hindered by continued use of these criteria.
KW - Histologic endometritis
KW - Pelvic inflammatory disease
KW - Plasma cell
KW - Syndecan-1
UR - http://www.scopus.com/inward/record.url?scp=82755182534&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=82755182534&partnerID=8YFLogxK
U2 - 10.1016/j.prp.2011.08.007
DO - 10.1016/j.prp.2011.08.007
M3 - Article
VL - 207
SP - 680
EP - 685
JO - Pathology Research and Practice
JF - Pathology Research and Practice
SN - 0344-0338
IS - 11
ER -