Peritoneal endometriosis and ''endometriotic'' nodules of the rectovaginal septum are two different entities
Peritoneal endometriosis and ''endometriotic'' nodules of the rectovaginal septum are two different entities
复制标题
DOI：
10.1016/s0015-0282(16)58501-x
复制
发表时间：
1996-09-01
影响因子：
6.7
通讯作者：
CasanasRoux, F
中科院分区：
文献类型：
--
作者：
Donnez, J;Nisolle, M;CasanasRoux, F
目的：比较直肠阴道隔子宫内膜异位症与腹膜子宫内膜异位症的组织学和体视学差异。设计：对来自腹膜（n = 52）和直肠阴道结节（n = 68）的子宫内膜异位症组织进行形态计量学调查、细胞角蛋白和静脉蛋白含量以及类固醇受体评估。环境：一所学术教学医院。患者：对120例因不孕症和盆腔疼痛接受腹腔镜检查的患者进行了活检（52例来自典型的黑色腹膜子宫内膜异位症植入物，68例来自直肠阴道间隔子宫内膜异位症结节）。所有患者均未接受治疗。结果：腹膜子宫内膜异位症与直肠阴道子宫内膜异位症有丝分裂活性有显著差异。评价提示间质不是直肠阴道结节腺上皮浸润的必要条件，直肠阴道结节与腺肌瘤一样，是平滑肌和腺体成分的界限分明的结节聚集。与异位子宫内膜相比，两种类型病变的细胞角蛋白和波形蛋白含量以及雌激素受体（ER）和P受体（PR）含量均显著降低。但在上皮细胞中的免疫反应性。与黑色腹膜病变相比，结节中的ER和PR含量明显降低。结论：提示直肠阴道子宫内膜异位症结节与腹膜子宫内膜异位症是不同的疾病，必须称为直肠阴道子宫腺肌症或直肠阴道腺肌瘤。其组织发病机制可能与反流子宫内膜细胞着床无关，而与苗勒氏管细胞化生有关。
Objective: To compare histologically and stereologically the endometriotic nodule of the rectovaginal septum to peritoneal endometriosis.Design: Morphometric investigation, cytokeratin and vimentin content, and steroid receptor evaluation were performed on endometriotic tissue from the peritoneum (n = 52) and rectovaginal nodules (n = 68).Setting: An academic teaching hospital.Patients: Biopsies were takes from 120 patients undergoing a laparoscopy for infertility and of pelvic pain (52 from typical black peritoneal endometriotic implants and 68: from endometriotic nodule of the rectovaginal septum). None of the patients were treated.Results: Mitotic activity was found to be significantly different, in peritoneal and rectovaginal endometriosis. The evaluation suggested that the stroma is not mandatory for the invasion of glandular epithelium in the rectovaginal nodule, which is, like a adenomyoma, a circumscribed nodular aggregate of smooth muscle and glandular elements. Cytokeratin and vimentin content as well as the estrogen receptor (ER) and P receptor (PR) content were significantly lower in both types of lesion when compared with eutopic endometrium. But vimentin immunoreactivity in epithelium. as well as the ER and PR content, were significantly lower in nodules when compared with black peritoneal lesions.Conclusion: It is suggested that the rectovaginal endometriotic nodule is a different disease from peritoneal endometriosis and must be called rectovaginal adenomyosis or rectovaginal adenomyoma. Its histopathogenesis probably is not related to the implantation of regurgitated endometrial cells but to the metaplasia of Mullerian rests.