Abstract
The focus of the presented work was to isolate and characterize circulating endometrial cells (CECs) enriched from peripheral blood (PB) of patients with diagnosed endometriosis. The molecular characteristics of CECs could be supportive for an understanding of endometriosis pathogenesis and treatment decisions in the future. Material and Methods: Blood samples (n = 423) were tested for CECs presence. Subsequently, gene expression analysis (GEA) was carried out for CECs. In parallel, CECs presence and characteristics were tested during menstrual cycle (MC) phases in 11 patients. CECs were enriched by size-based separation. Results: CECs were present in 78.4% of the tested blood samples. In line with the revised American Fertility Society (rAFS) classification, CECs presence was confirmed in all the acknowledged endometriosis stages: minimal, mild, moderate, and severe. Surprisingly, CECs negativity rate was also reported for severe disease in 21.1% of cases. The CECs captured during MC phases displayed different cytomorphology, including epithelial, stromal, and stem cell-like characteristics. The highest CECs numbers were detected in the mid-secretory phase of MC, which corresponds to uterine lining decidualization. CECs captured during mid-secretory periods expressed genes KRT18, NANOG, and VIM in higher amounts when compared to the proliferative phase of MC, where genes KRT19 and ESR1 were mostly elevated. GEA of the super-positive CECs samples (1000 CECs/8 mL PB) revealed high expression of genes KRT18, VIM, NANOG, and FLT1. The expression of these genes was also elevated in the endometriosis tissue samples and endometrioma. Conclusion: The panel of the identified CEC genes could be tested in a prospective manner to confirm the role of CECs in endometriosis pathogenesis and diagnostics.
Highlights
Endometriosis is a common disease among women of reproductive age and a major contributor to pelvic pain and subfertility causing disability and significantly compromised quality of life [1]
Four main circulating endometrial cells (CECs) subtypes can be found in blood sample of patients with endometriosis: epithelial, stem cell-like, stromal, and glandular
Our study confirmed the presence of CECs in most patients with histologically proven endometriosis
Summary
Endometriosis is a common disease among women of reproductive age and a major contributor to pelvic pain and subfertility causing disability and significantly compromised quality of life [1]. It affects up to 10% of women of reproductive age, 50–60% of women and two-thirds of teenage girls with pelvic pain and dysmenorrhea, and up to 50% of women with infertility [2,3]. There is no biomarker from the endometrium, blood, or urine or combined non-invasive tests specific enough to be used in clinical practice. Laparoscopy remains the gold standard for the diagnosis of endometriosis, and using non-invasive tests should only be undertaken in a research setting [1,5,6,7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
