Ettore Cicinelli1, Sergio Haimovich2,3, Dominique De Ziegler4, Nili Raz3, Dana Ben-Tzur3, Alessandra Andrisani5, Guido Ambrosini5, Nico Picardi1, Viviana Cataldo1, Marco Balzani1, Rossana Cicinelli1, Marco Noventa5, Loris Marin5, Pantaleo Greco6, Leonardo Resta7, Carlo Saccardi5, Giovanni Buzzaccarini8, Amerigo Vitagliano5. 1. Department of Biomedical and Human Oncological Science (DIMO), 2nd Unit of Obstetrics and Gynecology, University of Bari, Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy. 2. Department of Obstetrics and Gynecology, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain. 3. Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera. The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Hadera, Israel. 4. Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. 5. Department of Women's and Children's Health, University of Padua, via Nicolò Giustiniani 3, 35128, Padua, Italy. 6. Section of Gynecology and Obstetrics, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy. 7. Institute of Pathology, Faculty of Medicinecs, University of Bari, Bari, Italy. 8. Department of Women's and Children's Health, University of Padua, via Nicolò Giustiniani 3, 35128, Padua, Italy. giovanni.buzzaccarini@gmail.com.
Abstract
PURPOSE: The current gold standard for chronic endometritis (CE) diagnosis is immunohistochemistry (IHC) for CD-138. However, IHC for CD-138 is not exempt from diagnostic limitations. The aim of our study was to evaluate the reliability and accuracy of MUM-1 IHC, as compared with CD-138. METHODS: This is a multi-centre, retrospective, observational study, which included three tertiary hysteroscopic centres in university teaching hospitals. One hundred ninety-three consecutive women of reproductive age were referred to our hysteroscopy services due to infertility, recurrent miscarriage, abnormal uterine bleeding, endometrial polyps or myomas. All women underwent hysteroscopy plus endometrial biopsy. Endometrial samples were analysed through histology, CD138 and MUM-1 IHC. The primary outcome was to evaluate the diagnostic accuracy of MUM-1 IHC for CE, as compared with CD-138 IHC. RESULTS: Sensitivity and specificity of CD-138 and MUM-1 IHC were respectively 89.13%, 79.59% versus 93.48% and 85.03%. The overall diagnostic accuracy of MUM-1 and CD-138 IHC were similar (AUC = 0.893 vs AUC = 0.844). The intercorrelation coefficient for single measurements was high between the two techniques (ICC = 0.831, 0.761-0.881 95%CI). However, among CE positive women, MUM-1 allowed the identification of higher number of plasma cells/hpf than CD-138 (6.50 [SD 4.80] vs 5.05 [SD 3.37]; p = 0.017). Additionally, MUM-1 showed a higher inter-observer agreement as compared to CD-138. CONCLUSION: IHC for MUM-1 and CD-138 showed a similar accuracy for detecting endometrial stromal plasma cells. Notably, MUM-1 showed higher reliability in the paired comparison of the individual samples than CD-138. Thus, MUM-1 may represent a novel, promising add-on technique for the diagnosis of CE.
PURPOSE: The current gold standard for chronic endometritis (CE) diagnosis is immunohistochemistry (IHC) for CD-138. However, IHC for CD-138 is not exempt from diagnostic limitations. The aim of our study was to evaluate the reliability and accuracy of MUM-1 IHC, as compared with CD-138. METHODS: This is a multi-centre, retrospective, observational study, which included three tertiary hysteroscopic centres in university teaching hospitals. One hundred ninety-three consecutive women of reproductive age were referred to our hysteroscopy services due to infertility, recurrent miscarriage, abnormal uterine bleeding, endometrial polyps or myomas. All women underwent hysteroscopy plus endometrial biopsy. Endometrial samples were analysed through histology, CD138 and MUM-1 IHC. The primary outcome was to evaluate the diagnostic accuracy of MUM-1 IHC for CE, as compared with CD-138 IHC. RESULTS: Sensitivity and specificity of CD-138 and MUM-1 IHC were respectively 89.13%, 79.59% versus 93.48% and 85.03%. The overall diagnostic accuracy of MUM-1 and CD-138 IHC were similar (AUC = 0.893 vs AUC = 0.844). The intercorrelation coefficient for single measurements was high between the two techniques (ICC = 0.831, 0.761-0.881 95%CI). However, among CE positive women, MUM-1 allowed the identification of higher number of plasma cells/hpf than CD-138 (6.50 [SD 4.80] vs 5.05 [SD 3.37]; p = 0.017). Additionally, MUM-1 showed a higher inter-observer agreement as compared to CD-138. CONCLUSION: IHC for MUM-1 and CD-138 showed a similar accuracy for detecting endometrial stromal plasma cells. Notably, MUM-1 showed higher reliability in the paired comparison of the individual samples than CD-138. Thus, MUM-1 may represent a novel, promising add-on technique for the diagnosis of CE.
Authors: B Falini; M Fizzotti; A Pucciarini; B Bigerna; T Marafioti; M Gambacorta; R Pacini; C Alunni; L Natali-Tanci; B Ugolini; C Sebastiani; G Cattoretti; S Pileri; R Dalla-Favera; H Stein Journal: Blood Date: 2000-03-15 Impact factor: 22.113
Authors: Ettore Cicinelli; Stefano Bettocchi; Dominique de Ziegler; Vera Loizzi; Gennaro Cormio; Marco Marinaccio; Giuseppe Trojano; Francesco Maria Crupano; Roberta Francescato; Amerigo Vitagliano; Leonardo Resta Journal: J Minim Invasive Gynecol Date: 2019-01-29 Impact factor: 4.137