EVALUATION OF ENDOMETRIAL BIOPSIES FOR CHRONIC ENDOMETRITIS BY USING SYNDECAN-1 (CD138) IN ABNORMAL UTERINE BLEEDING

Objective: To determine the utility of Syndecan–1 (CD138) in the diagnosis of Chronic endometritis in patients with Abnormal Uterine Bleeding. Study Design: Cross-sectional study. Place and Duration: The study was carried out in department of Pathology, Army Medical College, Rawalpindi in collaboration with the department of Obstetrics & Gynecology, Pak Emirates Military Hospital (PEMH), Rawalpindi. The study duration was from Jan 2018 to Oct 2018. Methodology: A total of one hundred endometrial biopsies of patients with clinical or histological suspicion of chronic endometritis were taken. Hematoxylin and Eosin (H & E) stain was performed on all the biopsies and a diagnosis was made. Later on, Syndecan-1 was applied on all the biopsies and an immunohistochemical diagnosis was made. Both the diagnoses were then compared and analyzed. Results: Mean age of the study participants was 43.67 ± 8.95 years, with a range of 23-70 years. Out of 100 biopsies, forty-five cases (45%) were diagnosed as Chronic endometritis on H & E, while fifty-five cases (55%) were not showing Chronic endometritis and were diagnosed as disordered proliferative endometrium (DPE). On application of Syndecan-1 (CD 138), it was seen that these 19 out of 45 cases, diagnosed as Chronic endometritis on H & E were actually over-diagnosed and didn’t show plasma cells. Out of 55 cases which were negative for Chronic endometritis, 15 cases were underdiagnosed as they showed plasma cells with immunohistochemistry application (Syndecan-1). Conclusion: In cases suspected as Chronic endometritis, no plasma cells were clearly visible on H & E staining, Sydnecan-1 helps identifying plasma cells easily.