Standardized protocol for quantification of nerve bundle density as a biomarker for endometriosis

Autor: Gerbrand Zoet, Dwayne R. Tucker, Natasha L. Orr, Fahad T. Alotaibi, Yang Doris Liu, Heather Noga, Martin Köbel, Paul J. Yong
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Reproductive Health, Vol 5 (2023)
Druh dokumentu: article
ISSN: 2673-3153
DOI: 10.3389/frph.2023.1297986
Popis: IntroductionWe propose a standardized protocol for measurement of nerve bundle density in endometriosis as a potential biomarker, including in deep endometriosis (DE), ovarian endometriomas (OMA) and superficial peritoneal endometriosis (SUP).MethodsThis was a prospective cohort of surgically excised endometriosis samples from Dec 1st 2013 and Dec 31st 2017 at a tertiary referral center for endometriosis in Vancouver, BC, Canada. Surgical data were available from linked patient registry. Protein gene product 9.5 (PGP9.5) was used to identify nerve bundles on immunohistochemistry. PGP9.5 nerve bundles were counted visually. To calculate nerve bundle density, PGP9.5 nerve bundle count was divided by the tissue surface area (total on the slide). All samples were assessed using NHS Elements software for semi-automated measurement of the tissue surface area. For a subset of samples, high power fields (HPFs) were also counted as manual measurement of the tissue surface area. Intraclass correlation was used to assess intra observer and inter observer reliability. Generalized linear mixed model (GLMM) with random intercepts only was conducted to assess differences in PGP9.5 nerve bundle density by endometriosis type (DE, OMA, SUP).ResultsIn total, 236 tissue samples out of 121 participants were available for analysis in the current study. Semi-automated surface area measurement could be performed in 94.5% of the samples and showed good correlation with manually counted HPFs (Spearman's rho = 0.781, p
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