Clnical and pathological investigation of pelvic endometriosis

我们调查了以下相关细节，以阐明盆腔子宫内膜异位症的形态与生长的关系：(1)不同修订ASRM分期的腹腔液中IL-6、卵巢类固醇和肝细胞生长因子(HGF)浓度与子宫内膜异位症的形态特征的关系；(2)ASRM分类提出的不同颜色的形态病变中子宫内膜异位症的活性变化；(3)在位内膜活性与异位内膜活性的关系；(4)肝细胞生长因子可能参与盆腔间皮细胞的改变及其与巨噬细胞(M-φ)浸润的关系取决于盆腔子宫内膜异位症的活动性。(5)巨噬细胞(M-φ)在在位和异位内膜中的分布。我们分别得出以下结论：(1)子宫内膜异位症的早期分期和红色外观分别与Pf、HGF、IL-6和雌二醇的浓度升高有关；(2)不透明的红色病变的Pf和完整组织的活性均高于非混浊的红色病变或黑色病变；(3)子宫内膜异位症患者在位内膜中HGF和c-Met的免疫表达可能有助于预测异位内膜的活性；(4)盆腔内异位病变的邻近腹膜存在炎症反应，HGF可能参与了盆腔子宫内膜异位症腹膜间皮细胞的变化。(5)早期和活动期子宫内膜异位症的腹膜病变及其邻近腹膜含有丰富的M-φ，可能参与了子宫内膜异位症的生长。

We investigated the following relevant particulars to elucidate the relationship between morphological appearance and growth of pelvic endometriosis, (1)relationship between peritoneal fluid (PF) concentrations of interleukin-6, ovarian steroids and hepatocyte growth factor (HGF) in different revised-ASRM staging and morphologic appearances of endometriosis, (2)the variations of activity in the different colored morphologic lesions as proposed by the ASRM classification in women with endometriosis, (3)relationship between the activity of the eutopic endometrium and activity of the ectopic endometrium, (4)the possible involvement of HGF in the cellular changes of pelvic mesothelium and their association with macrophage (Mφ) infiltration depending on the activity of pelvic endometriosis, (5)the distribution of Mφ infiltration in eutopic and ectopic endometrium throughout the menstrual cycle. We obtained the following conclusions, respectively, (1)early staging and red color appearance of endometriosis are associated with the elevation in PF concentrations of HGF, IL-6 and estradiol, (2)both PF and intact tissue in opaque red lesions display higher activity than that in non-opaque red lesions, or black lesions, (3)immunoexpression of HGF and c-Met in the eutopic endometrium of patients with pelvic endometriosis is possibly useful to predict, greatei activity of the ectopic endometrium, (4)adjacent peritoneum of pelvic endometriotic lesions manifest an inflammatory response and HGF might be involved in the cellular change of peritoneal mesothelium in women with pelvic endometriosis, (5)the peritoneal lesions of early and active endometriosis and their adjacent peritoneum harbor abundant Mφ which could be involved in the growth of endometriosis.