Epithelial abnormalities in cystic ovarian endometriosis
Epithelial abnormalities in cystic ovarian endometriosis
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DOI：
10.1006/gyno.2001.6529
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发表时间：
2002-02-01
影响因子：
4.7
通讯作者：
Venturini, L
中科院分区：
文献类型：
--
作者：
Prefumo, F;Todeschini, F;Venturini, L
目标。目的探讨卵巢囊肿性子宫内膜异位症中上皮异常的发生率。在这项观察性研究中，对388例连续接受外科手术的最终诊断为囊肿性卵巢子宫内膜异位症的患者的标本进行了组织病理学检查。分析了子宫内膜异位症中上皮化、增生、异型及子宫内膜样癌的发病率及患者特点。339例可检测上皮内膜。左侧囊肿明显多于右侧囊肿（P < 0.0001）。化生的患病率为12.1%，增生为9.4%，异型为5.9%，子宫内膜异位症引起的子宫内膜样癌为4.1%。复合增生，而非单纯增生或化生，在伴有子宫内膜样癌的病例中比在所有其他病例中更常见（P < 0.00001）。从正常上皮到癌的年龄增长趋势有统计学意义（P < 0.001）。上皮异常是囊肿性卵巢子宫内膜异位症的常见发现。尽管其临床意义仍有争议，但复杂增生和异型可与子宫内膜异位症的恶性转化有关。在手术标本中观察，特别是在老年患者中，应仔细检查囊肿的整个内膜，并对患者进行严格的随访。(C) 2002 Elsevier Science。
Objective. To evaluate the prevalence of epithelial abnormalities in cystic ovarian endometriosis.Methods. In this observational study, the specimens of 388 consecutive patients undergoing a surgical procedure whose final diagnosis included cystic ovarian endometriosis were histopathologically reviewed. The prevalence and patient characteristics of cases featuring epithelial metaplasia, hyperplasia, atypia, and endometrioid carcinoma arising in endometriosis were analyzed.Results. The epithelial lining was evaluable in 339 cases. Left-sided cysts were significantly more common than right-sided ones (P < 0.0001). The observed prevalence was 12.1% for metaplasia, 9.4% for hyperplasia, 5.9% for atypia, and 4.1% for endometrioid carcinoma arising in endometriosis. Complex hyperplasia, but not simple hyperplasia or metaplasia, was significantly more common in cases with associated endometrioid carcinoma than in all other cases (P < 0.00001). A statistically significant trend for increasing age from normal epithelium to carcinoma was observed (P < 0.001).Conclusions. Epithelial abnormalities are a common finding in cystic ovarian endometriosis. Despite their clinical significance being still debated, complex hyperplasia and atypia can be associated with malignant transformation of endometriosis. Their observation in a surgical specimen, particularly in older patients, should indicate a careful examination of the entire lining of the cyst and a strict follow-up of the patient. (C) 2002 Elsevier Science.