子宫内膜异位症(Endometriosis)张喜.pptVIP

Free template from   EndometriosisWomen’s Hospital, School of Medicine Zhejiang University    Prof. Lin Jun Definition Endometriosis is usually defined as the presence of endometrial-like tissue, that is, glands and stroma, outside the endometrium in uterine cavity and myometrium. Common sites of endometriosis The most common sites： uterosacral ligament rectouterine pouch ovary Others： uterine serosa fallopian tube sigmoid colon (乙状结肠) outside of the pelvis : Umbilicus(脐) , bladder, kidney Prevalence present in 10%-15% of women in reproductive age group, especially from age 25 to 45 normally not seen before age 15 or after menopause early and more childbearing latest study: more frequent menses (cycle length ≤ 27 days ) and prolonged menstrual flow (≥ 1 week) 2 times risk Pathogenesis Theories of sources of ectopic endometrium Endometrial implanting theory (种植学说) ——Sampson 1921 endometrium transfer → implant →grow ⒈retrograde menstruation (经血逆流) theory ⒉transport by lymph and vein ⒊iatrogenic (医源性的) implantation Pathogenesis Theories of source of ectopic endometrium metaplasia theory(化生学说) inducement theory（诱导学说） Pathogenesis Factors related with endometriosis Genetic Abnormalities ：high risk in first-degree relatives Immunologic Factors : increased concentrations of white blood cells, cytokines, and growth factors —— IL-6、IL-8、TNF-α、MCP-1 inflammation: EMs lesions → chronic pelvic inflammation Pathology ectopic endometrium ↓ hemorrhage ↓ proliferation of fibrous tissue ＆ adhesions ↓ dark blue or dark brown spots ↓ scarring nodules or cysts Gross appearance : ova