Hepatocyte growth factor may be involved in cellular changes to the peritoneal mesothelium adjacent to pelvic endometriosis

Objective: To investigate the possible involvement of hepatocyte growth factor (HGF) in the cellular changes of pelvic mesothelium and the association of these changes with macrophage (Mphi) infiltration and the different stages of pelvic endometriosis. Design: Controlled clinical study using intact tissue. Setting: Nagasaki University School of Medicine, Nagasaki, Japan. Patient(s): Biopsy specimens from 25 red lesions, 20 black lesions of pelvic endometriosis and their adjacent peritoneum were excised either en bloc or separately during laparoscopy. Intervention(s): Hepatocyte growth factor and activated macrophage-marker CD68 were immunolocalized using respective antibodies, and were quantitated by a computer analyzed quantitative-histogram (Q-H) score and light microscopy, respectively. Main Outcome Measure(s): The possible immunoreaction of HGF near the endometriotic lesions and their adjacent peritoneal mesothelium was examined. The association between immunostaining of HGF and macrophage infiltration around these cells was also investigated. Result(s): A fraction of biopsy specimens of pelvic peritoneum revealed histologically proven change from normal flat to cuboidal or columnar cell types. In cuboidal cells or flat cells of mesothelium adjacent to red lesions, the immunoreaction of HGF, as expressed by the Q-H scores, was found to be significantly higher than in corresponding cells adjacent to black lesions. The flat or cuboidal cells of pelvic mesothelium surrounding the red lesions also demonstrated greater macrophage infiltration than the cells surrounding black lesions. The Q-H scores of HGF in the cuboidal or columnar cells surrounding the red lesions showed a statistically significant correlation with the accumulation of macrophage in the cells; no similar correlation was demonstrated for black lesions. Conclusion(s): Adjacent peritoneum of pelvic endometriotic lesions may manifest an inflammatory response. Hepatocyte growth factor might be involved in the cellular changes found in the peritoneal mesothelium of women with pelvic endometriosis. ((C) 2004 by American Society for Reproductive Medicine.)