Quantification of nucleolar channel systems Uniform presence throughout the upper endometrial cavity

Capsule:
Nucleolar channel systems appear uniformly throughout the upper endometrial cavity, excluding the lower uterine segment, and preferentially in the functional luminal layers of the endometrium, indicating uniform secretory transformation.

Authors:
Michael J. Szmyga, M.S., Eli A. Rybak, M.D., M.P.H., Edward J. Nejat, M.D., M.B.A., Erika H. Banks, M.D., Kathleen D. Whitney, M.D., Alex J. Polotsky, M.D., M.S., Debra S. Heller, M.D., U. Thomas Meier, Ph.D.

Volume 99, Issue 2, Pages 558-564, February 2013

Abstract:

Objective:
To determine the prevalence of nucleolar channel systems (NCSs) by uterine region applying continuous quantification.

Design:
Prospective clinical study.

Setting:
Tertiary care academic medical center.

Patients:
Forty-two naturally cycling women who underwent hysterectomy for benign indications.

Intervention:
NCS presence was quantified by a novel method in six uterine regions, fundus, left cornu, right cornu, anterior body, posterior body, and lower uterine segment (LUS), using indirect immunofluorescence.

Main Outcome Measures:
Percent of endometrial epithelial cells (EECs) with NCSs per uterine region.

Results:
NCS quantification was observer-independent (intraclass correlation coefficient [ICC] = 0.96) and its intra-sample variability low (coefficient of variability [CV] = 0.06). 11/42 hysterectomy specimens were midluteal, 10 of which were analyzable with 9 containing over 5% EECs with NCSs in at least one region. The percent of EECs with NCSs varied significantly between the lower uterine segment (6.1%; IQR = 3.0-9.9) and the upper five regions (16.9%; IQR = 12.7-23.4) with fewer NCSs in the basal layer of the endometrium (17% +/-6%) versus the middle (46% +/-9%) and luminal layers (38% +/-9%) of all six regions).

Conclusions:
NCS quantification during the midluteal phase demonstrates uniform presence throughout the endometrial cavity, excluding the LUS, with a preference for the functional, luminal layers. Our quantitative NCS evaluation provides a benchmark for future studies and further supports NCS presence as a potential marker for the window of implantation.

  • Tom Meier

    I will be happy to answer questions regarding the NCS, which we think essential for endometrial receptivity.

  • fdominguez

    Very interesting study about the NCS in different endometrial localizations. Congratulations for the spectacular immunofluorescence studies¡

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