Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link
Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link
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DOI：
10.1016/j.fertnstert.2017.05.016
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发表时间：
2017-08-01
影响因子：
6.7
通讯作者：
de Ziegler, Dominique
中科院分区：
文献类型：
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作者：
Cicinelli, Ettore;Trojano, Giuseppe;de Ziegler, Dominique
目的：探讨子宫内膜异位症与宫腔镜、常规组织学和免疫组化诊断的慢性子宫内膜炎（CE）的关系。设计：病例对照研究。单位：大学医院。患者：有或无子宫内膜异位症的切除子宫的妇女。干预措施：回顾性评价78例子宫切除术并有子宫内膜异位症的妇女和78例无子宫内膜异位症的妇女。主要观察指标：基于常规组织学和免疫组化诊断CE，使用抗syndecan-1抗体识别CD138细胞。结果：子宫内膜异位症患者的CE患病率明显高于无子宫内膜异位症患者（宫腔镜检查为78 / 33,42.3% vs.组织学检查为12 / 78,15.4%；组织学检查为30 / 78,38.5% vs. 11 / 78, 14.1%）。这些女性被分为两组，115例无CE， 41例有CE。单因素分析显示，胎次与CE风险降低相关，子宫内膜异位症与CE风险升高相关。通过多变量分析，胎次仍然与较低的CE发生率相关，而子宫内膜异位症与2.7倍的风险相关。结论：CE的诊断在子宫内膜异位症患者中更为常见。虽然不能确定CE与子宫内膜异位症之间的病因学关系，但本研究表明，对于子宫内膜异位症的妇女，特别是有异常子宫出血的妇女，应考虑并在必要时排除CE。CE的识别和适当的治疗可以避免不必要的手术。(C) 2017年由美国生殖医学学会出版。
Objective: To evaluate the association between endometriosis end chronic endometritis (CE) diagnosed by hysteroscopy, conventional histology, and immunohistochemistry.Design: Case-control study.Setting: University hospital.Patient(s): Women with and without endometriosis who have undergone hysterectomy.Intervention(s): Retrospective evaluation of 78 women who have undergone hysterectomy and were affected by endometriosis and 78 women without endometriosis.Main Outcome Measure(s): CE diagnosed based on conventional histology and immunohistochemistry with anti-syndecan-1 antibodies to identify CD138 cells.Result(s): The prevalence of CE was statistically significantly higher in the women with endometriosis as compared with the women who did not have endometriosis (33 of 78, 42.3% vs. 12 of 78, 15.4% according to hysteroscopy; and 30 of 78, 38.5% vs. 11 of 78, 14.1% according to histology). The women were divided into two groups, 115 patients without CE and 41 patients with CE. With univariate analysis, parity was associated with a lower risk for CE, and endometriosis was associated with a statistically significantly elevated risk of CE. Using multivariate analysis, parity continued to be associated with a lower incidence of CE, whereas endometriosis was associated with a 2.7 fold higher risk.Conclusion(s): The diagnosis of CE is more frequent in women with endometriosis. Although no etiologic relationships between CE and endometriosis can be established, this study suggests that CE should be considered and if necessary ruled out in women with endometriosis, particularly if they have abnormal uterine bleeding. Identification and appropriate treatment of CE may avoid unnecessary surgery. (C) 2017 by American Society for Reproductive Medicine.