ENDO Study: Endometriosis, Natural History and Diagnosis

ENDO研究是一项合作的流行病学研究，其目标是评估暴露于环境化学品与可能影响妇女生殖健康的生活方式因素之间的关系。正在评估持久性和非持久性化学物质与子宫内膜异位症事件诊断几率的关系。子宫内膜异位症是一种子宫内膜组织位于子宫外的情况，可能与盆腔疼痛、月经变化和不孕症有关。大约11%的18-44岁妇女可能受到影响，许多病例目前可能未被发现。到目前为止，子宫内膜异位症的原因尚不清楚，而且越来越多地怀疑是环境原因导致了一些受影响的妇女。 采用匹配的队列设计建立了两个女性队列--手术患者和人群患者。从旧金山和盐湖城地区的14家参与诊所招募了495名女性。这个手术队列在年龄和居住地上与参与临床中心的50英里集水区相匹配，以建立一个由131名女性组成的人群队列，她们接受了盆腔核磁共振检查，以确定是否患有子宫内膜异位症。 女性参与了基线访谈，并在手术或核磁共振之前提供了血液和尿液样本。如果可行，从手术队列中获得额外的手术生物标本(即大网膜脂肪、腹腔液、子宫内膜植入物)。 血清、脂肪和尿样已经进行了毒理学分析，以量化持续和短期的化学暴露，以评估它们与子宫内膜异位症的关系，并最终与其他妇科疾病，如子宫肌瘤。 许多持久和短暂的环境化学物质与子宫内膜异位症有关。然而，诊断子宫内膜异位症的方法不同(例如，通过手术或MRI可视化)，结果会有所不同。

The ENDO Study is a collaborative epidemiologic study whose goal is to assess the relation between exposure to environmental chemicals and lifestyle factors that may affect womens reproductive health. Both persistent and non-persistent chemicals are being assessed in relation to the odds of an incident diagnosis of endometriosis. Endometriosis is a condition in which endometrial tissue is found outside the uterus and can be associated with pelvic pain, menstrual changes and infertility. Approximately 11% of women aged 18-44 years may be affected, and many cases may be currently undetected. To date, the cause of endometriosis is unknown and, increasingly, an environmental etiology is suspected for some affected women. A matched cohort design was utilized to establish two cohorts of women - operative and population. 495 women were recruited from 14 participating clinics located in the San Francisco and Salt Lake City areas. This operative cohort was matched on age and residence with a 50-mile catchment area of participating clinical centers to establish a population cohort comprising 131 women who underwent pelvic MRIs to identify endometriosis or its absence. Women participated in baseline interviews and provided blood and urine samples priort to surgery or MRI. Additional operative biospecimens were obtained from the operative cohort when available (i.e., omentum fat, peritoneal fluid, endometrial implants). Serum, fat and urine samples have undergone toxicologic analysis for the quantification of persistent and short lived chemical exposures to assess their relation with endometriosis and, eventually, other gynecologic conditions such as fibroids. A number of persistent and short lived environmental chemicals have been associated with endometriosis. However, the findings vary by method of diagnosing endometriosis (for example by surgical or MRI visualization).