Abstract
Objective: In this study, our objective was to evaluate the abnormal collagen destruction and turnover and the prolidase activity in the etiopathogenesis of endometriosis, which may deteriorate the collagenous structure of exracellular matrix (ECM). Materials and Methods: For the assessment of the prolidase activity, venous blood samples were obtained from 37 patients, who had applied to the outpatient department of the Medical Faculty at Ondokuz Mayis University with complaints of pelvic pain, dysmenorrhea and infertility between October 1st, 2011 and February 15th, 2012, underwent clinical and ultrasonographic examination, prediagnosed with endometriosis, and scheduled for laparoscopy or laparotomy. A total of 22 patients, who were diagnosed with endometriosis via intraoperative exploration and/or pathological examination, constituted the study group and the remaining 15 patients, who did not have any pathological finding or were diagnosed with a benign disease except for endometriosis, constituted the control group. Serum samples obtained from all patients were first centrifuged and then stored in a freezer at -70 C until the time of analysis. During the analysis, the prolidase activity was measured following the necessary biochemical enzymatic processing. Results: We found a statistically significant difference between stage 4 and stage 1,2,3 patients in the study group regarding the CA 125 levels (p=0.018). On the other hand, there was no statistically significant difference between stage 1,2,3 patients in the study group and the control group for serum prolidase levels (p=0.778). There was a statistically significant difference between stage 4 endometriosis patients in the study group and the control group considering the serum prolidase levels (p=0.026). Conclusion: We conclude that serum prolidase activity has a critical function in the development of the endometriotic lesions. In endometriosis patients, the increase in the serum prolidase activity may play an important role in the progress to more advanced stages and in the development of infertility.
Highlights
Endometriosis is defined as the presence of endometrial gland and stroma outside the uterus cavity and muscular layer [1]
Materials and Methods: For the assessment of the prolidase activity, venous blood samples were obtained from 37 patients, who had applied to the outpatient department of the Medical Faculty at Ondokuz Mayıs University with complaints of pelvic pain, dysmenorrhea and infertility between October 1st, 2011 and February 15th, 2012, underwent clinical and ultrasonographic examination, prediagnosed with endometriosis, and scheduled for laparoscopy or laparotomy
Five patients had myoma uteri as a concomitant gynecological pelvic disease. 10 of the patients, who were diagnosed with endometriosis via laparoscopy and laparotomy, were operated due to the pre-diagnosis of pelvic pain, a pelvic mass
Summary
Endometriosis is defined as the presence of endometrial gland and stroma outside the uterus cavity and muscular layer [1]. The prevalence of endometriosis in the general population is unknown [1,2,3]. 12%-32% of patients, who underwent laparoscopy due to the pelvic pain, 9%-50% of patients, who underwent laparoscopy due to infertility and 50% of patients, who underwent laparoscopy due to the chronic pelvic pain or dysmenorrhea, were diagnosed with endometriosis [1,2,3]. The pathological process in endometriosis is not fully elucidated yet. The pathogenesis is not known, several theories based on certain evidence were proposed [1]. Retrograde menstruation – transplantation, coelomic metaplasia – induction, vascular dissemination and theories related to the immune system are among them. As endometriosis is usually encountered in women of reproductive age, the symptoms
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