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子宫内膜异位症(Endoetriosis)-张喜
Free template from EndometriosisWomen’s Hospital, School of Medicine Zhejiang University Prof. Lin Jun Definition Endometriosis is usually defined as the presence of endometrial-like tissue, that is, glands and stroma, outside the endometrium in uterine cavity and myometrium. Common sites of endometriosis The most common sites: uterosacral ligament rectouterine pouch ovary Others: uterine serosa fallopian tube sigmoid colon (乙状结肠) outside of the pelvis : Umbilicus(脐) , bladder, kidney Prevalence present in 10%-15% of women in reproductive age group, especially from age 25 to 45 normally not seen before age 15 or after menopause early and more childbearing latest study: more frequent menses (cycle length ≤ 27 days ) and prolonged menstrual flow (≥ 1 week) 2 times risk Pathogenesis Theories of sources of ectopic endometrium Endometrial implanting theory (种植学说) ——Sampson 1921 endometrium transfer → implant →grow ⒈retrograde menstruation (经血逆流) theory ⒉transport by lymph and vein ⒊iatrogenic (医源性的) implantation Pathogenesis Theories of source of ectopic endometrium metaplasia theory(化生学说) inducement theory(诱导学说) Pathogenesis Factors related with endometriosis Genetic Abnormalities :high risk in first-degree relatives Immunologic Factors : increased concentrations of white blood cells, cytokines, and growth factors —— IL-6、IL-8、TNF-α、MCP-1 inflammation: EMs lesions → chronic pelvic inflammation Pathology ectopic endometrium ↓ hemorrhage ↓ proliferation of fibrous tissue & adhesions ↓ dark blue or dark brown spots ↓ scarring nodules or cysts Gross appearance : ova
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