Altered Gene Expression Profile in Vaginal Polypoid Endometriosis Resembles Peritoneal Endometriosis and Is Consistent with Increased Local Estrogen Production

Background: In a university hospital setting, a 25-year-old woman presented with large vaginal and cervical polyps. Past medical history was significant for stage IV endometriosis. Polypectomy was performed and the polyps were histologically consistent with endometriosis. Gene expression was compared with control vaginal tissue to assess if the altered gene expression profile was similar to peritoneal endometriosis. Methods and Results: Using quantitative reverse transcription, real-time PCR, estrogen receptorexpression was found to be upregulated 10-fold while estrogen receptorexpression was downregulated 5-fold in the vaginal polyp relative to control vaginal tissue. The estrogen-synthesizing enzyme aromatase was upregulated 8-fold and 3 hydroxysteroid dehydrogenase was upregulated 400-fold in the polyp. Immunohistochemical staining revealed altered cell type localization for progesterone receptor in the polyp and increased cell proliferation in polyp stromal cells relative Received: September 23, 2009 Accepted after revision: March 28, 2010 Published online: December 9, 2010 Susan C. Nagel, PhD Department of Obstetrics, Gynecology and Women’s Health, University of Missouri DC051.00, M659 MSB, 1 Hospital Drive Columbia, MO 65212 (USA) Tel. +1 573 884 3028, Fax +1 573 882 9010, E-Mail nagels @ health.missouri.edu © 2010 S. Karger AG, Basel Accessible online at: www.karger.com/goi D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /4 /2 01 7 6: 10 :5 2 P M