Schultes G
Abteilung für Umwelt und Medizinische Wissenschaften, Donau-Universität Krems.
Wien Med Wochenschr. 1999;149(13):361-5.
Since 1985 the revised American Fertility Society (r-AFS) classification (renamed later American Society for Reproductive Medicine's classification--ASRM classification) has been a widely accepted system of categorizing the extent of endometriosis. The scoring system gives a detailed description of the location and the severity of the case and correlates to some extent with the degree of pain caused by endometriosis. Based upon collected data the classification was not found sensitive in predicting pregnancy according to the stage and after treatment of the disease. In view of this lack of sensitivity the ASRM has proposed not to change the scoring system, but additional color photographs are provided to assure consistency in describing the appearance of endometriosis. Changes in assessing cul-de-sac obliteration have been suggested to avoid future intra- and interobserver variations. Due to our insufficient understanding of the pathophysiology of endometriosis only a few new biomarkers can be offered for the prediction of fertility and management of pelvic pain. Animal studies and further controlled trials are needed to develop future parameters.
自1985年以来，修订后的美国生育协会（r-AFS）分类法（后来更名为美国生殖医学学会分类法——ASRM分类法）一直是广泛接受的子宫内膜异位症程度分类系统。该评分系统详细描述了病例的位置和严重程度，并在一定程度上与子宫内膜异位症引起的疼痛程度相关。根据收集的数据，该分类法在根据疾病阶段和治疗后预测妊娠方面并不敏感。鉴于这种缺乏敏感性的情况，ASRM提议不改变评分系统，但提供额外的彩色照片以确保在描述子宫内膜异位症外观时的一致性。有人建议改变对直肠子宫陷凹闭塞的评估，以避免未来观察者内部和观察者之间的差异。由于我们对子宫内膜异位症病理生理学的了解不足，因此只能提供少数新的生物标志物用于预测生育能力和管理盆腔疼痛。需要进行动物研究和进一步的对照试验来制定未来的参数。
