ENDO Study: Endometriosis, Natural History and Diagnosis

ENDO研究是一项合作流行病学研究，其目标是评估接触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。 持久性和非持久性化学物质正在评估与子宫内膜异位症诊断的可能性。 子宫内膜异位症是一种子宫内膜组织位于子宫外的疾病，可能与盆腔疼痛，月经变化和不孕有关。 大约11%的18-44岁的妇女可能受到影响，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，越来越多的人怀疑一些受影响的妇女的环境病因。 采用匹配队列设计建立两个女性队列-手术组和人群组。 从位于旧金山弗朗西斯科和湖城的14个参与诊所招募了495名妇女。 该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，以建立一个包括131名接受盆腔MRI以确定子宫内膜异位症或其缺失的妇女的人群队列。 妇女参加了基线访谈，并在手术或MRI前提供了血液和尿液样本。 当可用时，从手术队列获得额外的手术生物标本（即，网膜脂肪、腹膜液、子宫内膜植入物）。 对血清、脂肪和尿液样本进行了毒理学分析，以量化持续和短暂的化学品暴露，以评估其与子宫内膜异位症以及最终与其他妇科疾病（如肌瘤）的关系。 一些持久和短暂的环境化学物质与子宫内膜异位症有关。 然而，结果因诊断子宫内膜异位症的方法而异（例如通过手术或MRI可视化）。

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).