An update on the classification of endometriosis
An update on the classification of endometriosis
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DOI：
10.1097/00003081-199909000-00015
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发表时间：
1999-09-01
影响因子：
1.5
通讯作者：
Guzick, DS
中科院分区：
文献类型：
--
作者：
Hoeger, KM;Guzick, DS
关于子宫内膜异位症分类的争论从Sampson在20世纪20年代描述出血性卵巢囊肿和随后形成的粘连开始就一直在进行。尽管子宫内膜异位症作为一种疾病过程已被公认，但其病因、病理生理学和自然史仍不确定。理想情况下，疾病过程的分类系统应该允许基于表现相似的疾病阶段来预测结果。此外，同样可预测的治疗反应应与分期有关，允许分类系统预测预后以及对治疗的反应。目前的认识是，现有的子宫内膜异位症分类系统不能很好地满足这些标准。潜在的误差来源包括观察误差，因为子宫内膜异位症可能有许多不同的外观，对疾病病理生理的不完全了解，以及基于临床意见使用任意的断点和权重。2 - 5因此，人们普遍认为子宫内膜异位症的理想分类尚未实现。鉴于这一认识，我们将回顾目前修订的美国生殖医学学会（以前的AFS）分类和评分系统的发展及其局限性，以评估不孕和盆腔疼痛背景下的子宫内膜异位症。
The debate about the classification of endometriosis has been ongoing since the original work of Sampson in the 1920s describing hemorrhagic ovarian cysts and subsequent formation of adhesions. 1 Despite its long recognition as a disease process, the etiology, pathophysiology, and natural history of endometriosis remain uncertain. Ideally, a classification system for a disease process should allow for prediction of outcome based on stages of disease that behave similarly. In addition, similarly predictable responses to treatment should be related to stage, allowing a classification system to predict prognosis as well as response to treatment. There is current recognition that the existing system for endometriosis classification does not meet these criteria well. Potential sources of error include observational error, because endometriosis may have many different appearances, incomplete knowledge of the pathophysiology of the disease, and use of arbitrary breakpoints and weights based on clinical opinion. 2–5Thus, it is generally recognized that the ideal classification for endometriosis has not been achieved. Given this understanding, the development of the current revised American Society for Reproductive Medicine (formerly AFS) classification and scoring system and its limitations will be reviewed with respect to the evaluation of endometriosis in the context of infertility and pelvic pain.