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MUM-1 immunohistochemistry has high accuracy and reliability in the diagnosis of chronic endometritis: a multi-centre comparative study with CD-138 immunostaining

  • Reproductive Physiology and Disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

The current gold standard for chronic endometritis (CE) diagnosis is immunohistochemistry (IHC) for CD-138. However, IHC for CD-138 is not exempt from diagnostic limitations. The aim of our study was to evaluate the reliability and accuracy of MUM-1 IHC, as compared with CD-138.

Methods

This is a multi-centre, retrospective, observational study, which included three tertiary hysteroscopic centres in university teaching hospitals. One hundred ninety-three consecutive women of reproductive age were referred to our hysteroscopy services due to infertility, recurrent miscarriage, abnormal uterine bleeding, endometrial polyps or myomas. All women underwent hysteroscopy plus endometrial biopsy. Endometrial samples were analysed through histology, CD138 and MUM-1 IHC. The primary outcome was to evaluate the diagnostic accuracy of MUM-1 IHC for CE, as compared with CD-138 IHC.

Results

Sensitivity and specificity of CD-138 and MUM-1 IHC were respectively 89.13%, 79.59% versus 93.48% and 85.03%. The overall diagnostic accuracy of MUM-1 and CD-138 IHC were similar (AUC = 0.893 vs AUC = 0.844). The intercorrelation coefficient for single measurements was high between the two techniques (ICC = 0.831, 0.761–0.881 95%CI). However, among CE positive women, MUM-1 allowed the identification of higher number of plasma cells/hpf than CD-138 (6.50 [SD 4.80] vs 5.05 [SD 3.37]; p = 0.017). Additionally, MUM-1 showed a higher inter-observer agreement as compared to CD-138.

Conclusion

IHC for MUM-1 and CD-138 showed a similar accuracy for detecting endometrial stromal plasma cells. Notably, MUM-1 showed higher reliability in the paired comparison of the individual samples than CD-138. Thus, MUM-1 may represent a novel, promising add-on technique for the diagnosis of CE.

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All data are available upon request.

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Acknowledgements

University of Bari, University of Padua, University of Barcelona.

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Authors and Affiliations

  1. Department of Biomedical and Human Oncological Science (DIMO), 2nd Unit of Obstetrics and Gynecology, University of Bari, Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy

    Ettore Cicinelli, Nico Picardi, Viviana Cataldo, Marco Balzani & Rossana Cicinelli

  2. Department of Obstetrics and Gynecology, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain

    Sergio Haimovich

  3. Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera. The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Hadera, Israel

    Sergio Haimovich, Nili Raz & Dana Ben-Tzur

  4. Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Dominique De Ziegler

  5. Department of Women’s and Children’s Health, University of Padua, via Nicolò Giustiniani 3, 35128, Padua, Italy

    Alessandra Andrisani, Guido Ambrosini, Marco Noventa, Loris Marin, Carlo Saccardi, Giovanni Buzzaccarini & Amerigo Vitagliano

  6. Section of Gynecology and Obstetrics, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy

    Pantaleo Greco

  7. Institute of Pathology, Faculty of Medicinecs, University of Bari, Bari, Italy

    Leonardo Resta

Authors
  1. Ettore Cicinelli
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for the International Working Group for Standardization of Chronic Endometritis Diagnosis

Corresponding author

Correspondence to Giovanni Buzzaccarini.

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Cicinelli, E., Haimovich, S., De Ziegler, D. et al. MUM-1 immunohistochemistry has high accuracy and reliability in the diagnosis of chronic endometritis: a multi-centre comparative study with CD-138 immunostaining. J Assist Reprod Genet 39, 219–226 (2022). https://doi.org/10.1007/s10815-021-02356-1

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