Introduction: The menstrual reflux containing viable endometrial cells precede the development of endometriosis lesion. Based on that, we can assume that we can detect the presence of endometriosis by utilizing the endometrial cells in the menstrual blood sloughing. The purpose of this study was to prove that simple immunocytochemistry technique on a sample of menstrual blood may show endometrial cells. Materials and methods: A case–control study involving 60 women was performed, from February 2007 to February 2008. Screening for suspected endometriosis was performed by history taking, physical diagnosis and additional examination. Diagnostic laparoscopy or laparotomy and biopsy were performed afterward. Endometriosis histopathologically defined as the presence of epithelial cells of endometrial glands and stroma in the tissue being examined. Menstrual blood sampling is performed by taking 20 drops of blood into 20 mL preservative solution. In this study, the cells/tissues staining by immunohistochemistry using diaminobenzene (DAB), and for comparison hematoxylin–eosin staining (HE) was used so that the stromal cells which express caspase-3, caspase-9 and MMP-9 are stained brown with a blue background. Results: The endometrial cells were successfully isolated using a preservative solution, and all samples from endometriosis subjects could be analyzed for the expression of caspase-3, caspase-9, and MMP-9. Discussion: The results of this study lead to a conclusion that immunocytochemistry analysis of the menstrual blood endometrial cells can be applied as a noninvasive method for establishing the diagnosis of endometriosis in daily practice.
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