CO2-LASER EXCISION OF ENDOMETRIOSIS DOES NOT IMPROVE THE DECREASED NATURAL-KILLER ACTIVITY

Objective. We recently described a decreased lymphocyte-mediated cytot oxicity to autologous endometrium and to natural killer-sensitive targ ets in women with endometriosis. The purpose of the present study was to investigate whether the defect remained after CO2-laser excision of the endometriotic lesions. Design. In 15 women with endometriosis the cytotoxicity assays were performed before and three to four months af ter complete removal of the endometriotic lesions with CO2-laser excis ion. CA-125 serum levels were measured before and after laser laparosc opy, in order to confirm that endometriosis had been treated properly. Results. After removal of the endometriotic lesions the decreased nat ural killer activity (K562-assay) and the impaired cytotoxicity of aut ologous and even heterologous lymphocytes to the endometrium remained unchanged, and those cytotoxicity assays were still significantly decr eased compared to the women without endometriosis. CA-125 serum concen trations, however, were still significantly decreased three to four mo nths after CO2-laser excision of the endometriosis. (paired Student's t-test p < 0.007). Conclusions. These data suggest a primary deficienc y in natural killer activity in women with endometriosis and are in ac cordance with our clinical experience as endometriosis is relapsing fr equently after treatment.