Immunohistochemical Characterization of Leukocytic Subpopulations in Chronic Endometritis

[摘要] Objective:We analyzed the histologic and immunohistochemical changes in the endometrial leukocyticsubpopulations to determine which of them are characteristic of chronic endometritis.Results:Endometrial biopsies from 25 cases of chronic endometritis and 35 controls were studied.Characteristic morphologic findings included the presence of a plasma cell infiltrate, and a prominent,albeit non-specific, lymphocytic infiltrate in all patients with endometritis. A neutrophilicinfiltrate was also noted in 90% of the patients. Other non-specific histologic findings includedoccasional prominent lymphoid aggregates, stromal edema, hemorrhage, and necrosis and cysticdilation of some glands in endometria of patients with chronic endometritis. Endometrial immunecells were investigated immunohistochemically using antibodies to CD3 (pan-T), CD20 (pan-B,L26), and Ham-56 (macrophage). In control patients, endometrial immune cells were predominantlycomposed of CD3 and Ham-56 positive cells. CD20 positive cells comprised <2% of immunecells in control patients [mean: <2 cells/high power field (HPF)]. Large numbers of CD20 and CD3lymphocytes were seen in endometria of patients with chronic endometritis. A semiquantitativeanalysis showed that the numbers of CD20 and CD3 positive cells in patients with chronic endometritiswere increased 50- and 3-fold, respectively, when compared to those of control patients(mean B cells: 49 vs. 2 cells/HPF; mean T cells: 149 vs. 45 cells/HPF). CD20 positive cells werepredominantly seen in subepithelial and periglandular aggregates. CD3 positive cells had a predominantstromal distribution and an occasional intra- or subepithelial localization. There was nodifference in the number and distribution of Ham-56 positive cells in patients with or withoutendometritis.Conclusions:These findings suggest that CD20 cells may have a significant role in the pathogenesisof chronic endometritis and that immunostaining for B and T lymphocytes could be used inconfirming the diagnosis of endometritis or in diagnosing subclinical or progressing endometritis inwhich plasma cells could not be detected or are rarely identified.

[学科分类] 妇产科学