EVALUATION OF ENDOMETRIAL BIOPSIES FOR CHRONIC ENDOMETRITIS BY USING SYNDECAN-1 IN ABNORMAL UTERINE BLEEDING

ABSTRACT Objective: To determine the utility of Syndecan-1 (CD138) in the diagnosis of Chronic endometritis in patients with Abnormal Uterine Bleeding. Study Design: Cross-sectional study. Place and Duration: The study was carried out in department of Pathology, Army Medical College, Rawalpindi in collaboration with the department of Obstetrics and Gynecology, Pak Emirates Military Hospital (PEMH), Rawalpindi. The study duration was from Jan 2018 to Oct 2018. Methodology: A total of one hundred endometrial biopsies of patients with clinical or histological suspicion of chronic endometritis were taken. Hematoxylin and Eosin (H and E) stain was performed on all the biopsies and a diagnosis was made. Later on, Syndecan-1 was applied on all the biopsies and an immunohistochemical diagnosis was made. Both the diagnoses were then compared and analyzed. Results: Mean age of the study participants was 43.67 ± 8.95 years, with a range of 23-70 years. Out of 100 biopsies, forty-five cases (45%) were diagnosed as Chronic endometritis on H and E, while fifty-five cases (55%) were not showing Chronic endometritis and were diagnosed as disordered proliferative endometrium (DPE). On application of Syndecan-1 (CD 138), it was seen that these 19 out of 45 cases, diagnosed as Chronic endometritis on H and E were actually over-diagnosed and didn't show plasma cells. Out of 55 cases which were negative for Chronic endometritis, 15 cases were underdiagnosed as they showed plasma cells with immunohistochemistry application (Syndecan-1). Conclusion: In cases suspected as Chronic endometritis, no plasma cells were clearly visible on H and E staining, Sydnecan-1 helps identifying plasma cells easily.