Objective: To investigate the abnormal distribution of lymphocytes in eutopic and ectopic endometrium of patients with endometriosis and its significance.
Methods: In 43 cases, biopsies of ectopic tissues were taken by laparoscopy and laparotomy from patients with endometriosis and eutopic endometrium by curettage at the same time. In 19 cases, eutopic endometrium was taken from hysterectomy for myomatous uterus. Immunohistochemical techniques were employed to demonstrate the difference in the number and ratio of the lymphocyte subsets between the patients with endometriosis and the controls.
Results: In the patients with endometriosis, in the proliferative phase, ectopic endometrium contained respectively CD3+ CD8+ T cells and CD68+ macrophages (67.2 +/- 13.5)/5 HP, (45.0 +/- 14.0)/5 HP and (37.2 +/- 10.6)/5 HP, significantly higher then that in the eutopic endometrium (52.4 +/- 11.3)/5 HP (P < 0.01), (32.5 +/- 10.0)/5 HP (P < 0.05), and (30.7 +/- 10.3)/5 HP, and also higher as compared with the control group (52.1 +/- 14.9)/5 HP (P < 0.05), (28.9 +/- 12.7)/5 HP (P < 0.01), (26.3 +/- 9.3)/5 HP (P < 0.05); in the secretory phade, CD8+/CD4+, and CD68+ content was respectively 3.5 +/- 1.2, (40.3 +/- 12.2)/5 HP, higher than that in the control group, 3.2 +/- 0.8 (P < 0.05), (28.6 +/- 10.6)/5 HP (P < 0.01). The number of macrophages was also significantly increased. No cyclic changes in the number of lymphocytes in each subpopulation in ectopic endometrium were found.
Conclusions: In the patients with endometriosis, the changes in T lymphocytes and macrophages are mainly on the endometriotic sites. The infiltration of many lymphocytes and macrophages into the ectopic endometrium formed a chronic inflammatory process. The lymphocytes are not able to clear the ectopic endometrium in the late stages of endometrium, on the contrary, they stimulate the further growth of the endometrium.