Abstract
OBJECTIVE: This study aimed to examine expression of cellular adhesion molecules and metalloproteinases of the extracellular matrix in ectopic endometrium for evaluating their roles in recurrence of endometriosis. METHODS: This study retrospectively analyzed 49 female patients (mean age: 30.1±5.5 years) with endometriomas who had undergone two separate operations. After a maximum follow-up of 80 months, all participants were divided into the recurrent group or nonrecurrent (control) group. Samples were immunostained for epithelial cadherin (E-cadherin), β-catenin, urokinase plasminogen activator (uPA), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of matrix metalloproteinase-2, and extracellular matrix metalloproteinase inducer (EMMPRIN). RESULTS: In the recurrent group, E-cadherin concentrations in the membrane and cytoplasm of ectopic endometrial glandular cells were significantly reduced, while those of MMP-9 and EMMPRIN were higher than those in the control group. Additionally, uPA concentrations in the membrane and cytoplasm of ectopic endometrial glandular, stromal, and vascular endothelial cells were significantly higher in the recurrent group than in the control group. Tissue inhibitor of matrix metalloproteinase-2 and β-catenin concentrations were similar between the groups. CONCLUSION: E-cadherin, MMP-9, and associated factors may contribute to development of endometriosis. E-cadherin, MMP-9, and uPA may act as potential markers for detection of recurrence of endometriosis.