STROMAL-EPITHELIAL COMMUNICATIONS IN HYPERPLASTIC HUMAN ENDOMETRIUM

OBJECTIVE: Our objective was to assess the cell-to-cell contacts in hy perplastic human endometrium and to compare them with contacts in norm al endometrium. STUDY DESIGN: Hyperplastic endometrial samples (five w ith simple hyperplasia and five with complex hyperplasia) without atyp ia by light microscopy were studied with transmission electron microsc opy. The cell-to-cell contacts, basal lamina, and epithelial-to-stroma l compartment contacts were studied and compared with these same areas in normal endometrium. RESULTS: Only infrequent gap junctions between epithelial cells were seen. Other epithelial contacts were also great ly reduced when compared with normal epithelium. Cell-to-cell contacts between the epithelial compartment and the stromal compartment were r are and degenerative in configuration. An increase in extracellular ma trix and various alterations in the basal lamina appears to contribute to a decrease in cell-to-cell contacts. CONCLUSIONS: Compared with no rmal endometrium, hyperplastic endometrium demonstrated far fewer cell -to-cell contacts. The basal lamina and extracellular matrix were alte red in such a fashion that communication between the stromal and epith elial compartments appeared to be impaired. Stromal and epithelial cel ls rarely were in contact. Those contacts present were less complex an d the majority were degenerative. Hyperplasia without atypia demonstra ted a much lower amount of intercellular communication than normal end ometrium.