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Objective To determine whether the proportion of several leukocyte subsets is modulated in the endometrium of patients with endometriosis and, if yes, whether it can be used for diagnostic purposes. Design: Case-control study. Setting: Eight clinical institutions of the Montreal area. Patient(s): Women who underwent laparoscopy or laparotomy between 1997 and 2001, who had regular menstrual cycles and were not under hormone treatment for the previous 3 months were selected. This study included 368 women, 173 with surgically confirmed endometriosis and 195 controls with no surgical evidence of endometriosis. Intervention(s): Main outcome measure(s): Cytometry analysis was used to measure the proportion of several leukocyte subsets among CD45 + endometrial cells. Result(s): The proportion of CD3 + , CD16 + , CD3 − HLADR − , CD3 - CD45RA − , CD3 + CD16 − , CD3 + CD56 − , CD56 − CD16 + , and CD16b + leukocytes was significantly altered in the endometrium of cases compared with controls. A multiple logistic regression model was adjusted with these endometrial leukocytes, serum CA-125 levels, risk factors, and confounders. The diagnostic performance of this predictive model was defined by a specificity of 95% and a sensitivity of 61%. Furthermore, the positive and negative predictive values were 91% and 75%, respectively. Conclusion(s) This predictive model represents a novel diagnostic tool to identify women with a high likelihood of suffering from endometriosis.

Objective To determine whether blood leukocyte populations could be modulated in endometriosis. Design Case-control study. Setting Eight clinical institutions of the Montreal area. Patient(s) Women with regular menstrual cycles who underwent laparoscopy or laparotomy between 1997 and 2001 and who were not under hormonal treatment for at least 3 months were selected. This study includes 175 cases and 131 controls. Main outcome measure(s) The proportion of blood leukocytes expressing markers for T, B lymphocytes, monocytes, or natural killer (NK) cells were compared by flow cytometric analysis between cases and controls. Result(s) Age and parity were identified as important confounders. Given that smoking, history of acute infection, and previous use of oral contraceptives strongly correlate with the level of some blood leukocyte populations, these parameters were taken into account in addition with age and parity when the level of blood leukocyte subsets were evaluated in cases and controls. Blood monocytes expressing CD14 and CD44 molecules were increased in patients with endometriosis. Alternatively, B lymphocytes were shown to be significantly decreased in cases compared with controls. Conclusion(s) Although these results suggest that endometriosis is associated with some systemic manifestations, the exact role of these modulations remains unclear.