Immunohistochemical Evaluation of Potential Biomarkers for Targeted Intraoperative Fluorescence Imaging in Endometriosis: Towards Optimizing Surgical Treatment.

Autor: Tummers FHMP; Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands. f.h.m.p.tummers@lumc.nl., de Koning R; Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands., Bazelmans MK; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Jansen FW; Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands.; Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands., Blikkendaal MD; Endometriose in Balans, Haaglanden Medical Center, The Hague, The Netherlands.; Nederlandse Endometriose Kliniek, Reinier de Graaf Hospital, Delft, The Netherlands., van Vlierberghe RLP; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Vahrmeijer AL; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Hazelbag HM; Department of Pathology, Haaglanden Medical Center, The Hague, The Netherlands., Kuppen PJK; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: Reproductive sciences (Thousand Oaks, Calif.) [Reprod Sci] 2024 Dec; Vol. 31 (12), pp. 3705-3718. Date of Electronic Publication: 2024 Oct 07.
DOI: 10.1007/s43032-024-01715-4
Abstrakt: Surgical intervention for endometriosis is an important treatment modality, yet incomplete resection resulting from poor visibility of affected tissue and consequently recurrence of disease remains a prevalent challenge. Intra-operative visualization of endometriosis, enabling fluorescence-guided surgery (FGS), could help to optimize surgical treatment. A biomarker, upregulated in endometriosis compared to adjacent tissue, is required to use as a target for FGS. Immunohistochemistry was used to evaluate protein expression of a selection of previously identified potential biomarkers. Ten biomarkers were stained in a large cohort of 84 tissues, both deep and peritoneal endometriosis and tissue without endometriosis, all from patients with confirmed endometriosis. MMP11 and VCAN showed the largest upregulation in endometriosis compared to adjacent tissue and showed a membranous or extracellular staining pattern. MMP11 is a promising target for glandular and stromal visualization, VCAN for stromal visualization only. For both biomarkers, upregulation was high in both peritoneal and deep endometriosis and for patients with and without hormonal medication. Other stained biomarkers showed non-beneficial characteristics based on staining pattern or upregulation. Analysis of all endometriosis samples showed that combined glandular and stromal targeting is expected to result in optimal visualization of endometriosis. Further research is needed to determine whether targeting one biomarker is sufficient for this goal, or if dual targeting is necessary. Development of clinical tracers for VCAN and MMP11 is necessary.
Competing Interests: Declarations. Ethics Approval: The study protocol was approved by the Medical Ethical Committee Leiden Delft The Hague (METC LDD, B21.033). Tissue specimens were collected from patients who provided written informed consent. Competing Interests: No funds, grants, or other support was received. The authors have no competing interests to declare that are relevant to the content of this article.
(© 2024. The Author(s).)
Databáze: MEDLINE
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