Steroid and growth factor regulation of matrix metalloproteinase expression and endometriosis
Steroid and growth factor regulation of matrix metalloproteinase expression and endometriosis
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DOI：
10.1055/s-2007-1016334
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发表时间：
1996-08-01
期刊：
影响因子：
--
通讯作者：
Sharpe-Timms, KL
中科院分区：
文献类型：
--
作者：
Osteen, KG;Bruner, KL;Sharpe-Timms, KL
子宫内膜异位症的定义是子宫内膜腺体和间质在子宫外部位的存在。这种疾病的报告发病率变化很大，文献中的估计值通常在所有育龄妇女的10%至15%之间，在诊断为不孕症的妇女中为25%至35%。1虽然子宫内膜异位症通常不会危及生命，但可导致大量妇科问题，包括性交困难，痛经，盆腔不适和不孕症。这种疾病的病理生理学是有争议的，已经发展了几种理论来解释这种疾病的大多数发病率。也许最古老和最广泛接受的理论是逆行月经，导致异位植入的组织回流通过输卵管和腹膜腔。Sampson 4假设月经期间脱落的子宫内膜组织可能含有潜在的活性、类固醇敏感的组织碎片，能够植入子宫外，导致子宫内膜异位症。植入理论得到了各种实验观察的支持，包括灵长类动物手术诱导逆行月经后子宫内膜异位症的发展。5在人体研究中，Ridley和Edwards6，7在15名自愿允许腹膜注射月经组织的妇女中，有2名成功诱导了子宫内膜异位症。月经组织经常在月经期间接受手术的妇女的腹膜间隙中被注意到，8并且据报道，手术期间子宫内膜组织意外引入体腔会导致子宫内膜异位症。子宫内膜异位症最常发生在卵巢、子宫和支持韧带的表面，这些区域是回流的月经组织聚集的地方。然而，逆行月经理论本身不能解释所有的位置，这种疾病已被确定，包括罕见的情况下，子宫内膜异位症的男性。10.子宫内膜异位症发生的主要理论是M细胞膜化生，因为这种胚胎组织的残余物在成年男女中都存在。子宫内膜异位症被认为是在双侧睾丸切除术和前列腺癌雌激素治疗后的男性M氏残端发展而来的。虽然女性子宫内膜异位症可能是由于刺激了子宫内膜下动脉而发生的，但人们认为这种疾病最常见的原因是反流月经组织的植入。图12细胞机制，
The disease endometriosis is defined as the presence of endometrial glands and stroma at an extrauterine site. The reported incidence of this disease is highly variable, and estimates in the literature typically range between 10% and 15% for all reproductive age women and 25% to 35% in women diagnosed with infertility. 1 Although not usually a lifethreatening condition, endometriosis can result in a vast array of gynecological problems including dyspareunia, dysmenorrhea, pelvic discomfort, and infertility. The pathophysiology of the disease is controversial, and several theories have been developed that appear to explain most incidences of this disease. 2, 3 Perhaps the oldest and most widely accepted theory is that of retrograde menstruation, resulting in ectopic implantation of tissue refluxed through the fallopian tubes and into the peritoneal space. Sampson4 postulated that endometrial tissue sloughed during menstruation could contain potentially viable, steroid-sensitive tissue fragments capable of implanting outside the uterus, resulting in endometriosis. The implantation theory is supported by a variety of experimental observations including the development of endometriosis following the surgical induction of retrograde menstruation in primates. 5 In human studies, Ridley and Edwards6, 7 successfully induced endometriosis in 2 of 15 women who voluntarily allowed peritoneal injection of menstrual tissue. Menstrual tissue has often been noted in the peritoneal space of women undergoing surgery at the time of menstruation, 8 and accidental introduction of endometrial tissue into the body cavity during surgery has been reported to result in endometriosis. 9 Also in support of retrograde menstruation as a component of this disease, endometriosis occurs most often on the surface of the ovaries, uterus, and supporting ligaments, areas in which refluxed menstrual tissue would accumulate. However, the retrograde menstruation theory alone cannot account for all the locations in which this disease has been identified, including the rare cases of endometriosis in men. 10 M № llerian metaplasia is the principal alternative theory for the development of endometriosis because remnants of this embryological tissue remain in the adult of both sexes. Endometriosis is believed to develop from M № llerian rests in men following bilateral orchiectomy and estrogen therapy for prostate cancer. 11 Although it is likely that endometriosis in women can develop from stimulation of M № llerian rests, the disease is believed to most often result from the implantation of refluxed menstrual tissue. 12 The cellular mechanisms that