A CLINICO-PATHOLOGICAL STUDY ON ENDOMETRIOSIS WITH SPECIAL REFERENCE TO THE CD10 MARKER

BACKGROUND Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterine cavity and is characterized by recurrent episodes of pelvic pain and dysmenorrhea. The high prevalence of the disease along with its recurrent persistent nature poses a significant burden on the healthcare system of a country. Considering the enormity of the healthcare burden and the impact it has on the quality of life of the patients, here was a need to develop a marker which may help in the definitive diagnosis of this dreadful disease. The aim of this study is to corroborate the histopathological diagnosis of endometriosis with the immunohistochemical staining for CD10 and to find out the diagnostic efficacy of CD10 for endometriosis among clinically diagnosed patients of endometriosis. METHODS Patients admitted with suspected endometriosis and planned for operation in the Department of Gynaecology and Obstetrics, at North Bengal Medical College and Hospital in that year who gave informed consent for the study were included in the study provided they satisfied the inclusion and exclusion criteria. A representative histological block from each of the biopsy specimen harvested during the surgery of patients of endometriosis was chosen for immunohistochemistry for CD10. Correlation of CD-10 antigen expression was done with the post-operative histopathological findings. RESULTS Immunohistochemistry with CD10 increased the diagnostic yield of endometriosis cases. Cases diagnosed as endometriosis by routine histopathology were found to be positive for CD10. In others, CD10 positivity was also seen in those characterised by haemorrhagic cysts and endometriotic stroma. CONCLUSIONS CD10 immunostaining can be used to give a definitive diagnosis in cases where previously the pathologist would report as being "consistent with endometriosis" even in the absence of endometrial epithelium. We strongly recommend the use of CD10 IHC to confirm or exclude the diagnosis in cases of presumptive endometriosis and in those mistaken for this entity.