Endometrial aromatase mRNA as a possible screening tool for advanced endometriosis and adenomyosis

Endometriosis (ENDs) and adenomyosis (ADNs) are estrogen-dependent diseases. The aim of this study was to determine the clinical usefulness of examining endometrial biopsy specimens for aromatase cytochrome P450 (CYP19) as a diagnostic importance for endometriosis and adenomyosis. In general, the RT-PCR analyses of 101 samples revealed increased aromatase mRNA expression in eutopic endometrium in women with endometriosis and adenomyosis compared to healthy controls (p = 0.0002). The highest number of positive cases (93.3%) of CYP19 mRNA expression was detected in women with advanced disease stages. Concrete expression of CYP19 mRNA level in controls was 0.68 compared to patients with ADNs (1.21), ENDsL stage I-II (1.15) and ENDsA stage III-IV (1.65) (p < 0.0001), respectively. The possible influence of increased body mass index on aromatase expression in each group showed in controls an insignificant slight increase of aromatase expression, contrary to cases where this trend was the opposite. The results point to the higher (2.45-fold) difference in aromatase expression in patients with endometriosis stage III-IV compared to controls and provide direct evidence that screening for eutopic endometrial aromatase expression in combination with clinical data could be of discriminative value in the prediction of estrogen-dependent diseases, independent from body mass index.