ENDOMETRIAL GLANDULAR CELLS ARE FOUND EQUALLY IN THE PERITONEAL FLUIDS OF WOMEN WITH OR WITHOUT ENDOMETRIOSIS THROUGHOUT THE MENSTRUAL CYCLE. HJ Kliman, A Arici, DL Olive, EL Meaddough, KS Ahn, F Comite, E Attar. Departments of Pathology and Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT

Objective: Although retrograde menstruation is considered to be a near universal phenomenon-only a distinct subset of women suffer from endometriosis. It is not know if this subset of women are prone to endometriosis because they deposit more endometrial debris into their peritoneal cavities or their peritoneal cavities contain endometrial debris for a longer period of time. We therefore sought to determine if there are any differences in the amounts of endometrial glandular cells in peritoneal fluids from women with and without endometriosis throughout the menstrual cycle.

Design: Peritoneal fluid was collected during the menstrual cycle from women with and without endometriosis and analyzed for the presence of menstrual debris.

Material and Methods: 5-30 ml of peritoneal fluid collected from patients throughout the menstrual cycle were centrifuged, the pellets fixed in Bouin's, and stained with antibodies against low-molecular weight cytokeratins (CK), epithelial membrane antigen (EMA), and vimentin to identify endometrial glandular cells and mesothelial cells. Endometrial glandular cells were characterized by CK+EMA positivity and vimentin negativity, while mesothelial cells were identified by CK+vimentin positivity and EMA negativity.

Results: When frequency of peritoneal specimens with endometrial glandular cells in control and endometriosis patients were plotted against cycle day, no significant differences were noted (Figure).

Conclusions: These results suggest that endometrial glandular cells exist in the peritoneal cavities of both types of patients throughout the menstrual cycle. Therefore other factors-such as the absolute amount of tissue present; ability to remove debris; and interactions with other cell types, such as macrophages and mesothelial cells-may be more important in the pathogenesis of endometriosis than the presence or absence of endometrial debris in the peritoneal fluid. Supported by a Shannon Award from NICHD (HJK).

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