Moen M H, Halvorsen T B
Department of Obstetrics and Gynecology, University Hospital of Trondheim, Norway.
Acta Obstet Gynecol Scand. 1992 Jul;71(5):337-42. doi: 10.3109/00016349209021069.
The aim of this study was to compare the macroscopic evaluation of peritoneal abnormalities suspected of endometriosis with the histologic examination of the tissue. Peritoneal biopsies from 152 patients investigated for gynecological problems (94) or undergoing tubal sterilization (58) were taken from macroscopically abnormal peritoneum, and examined for the presence of endometriosis. Endometriosis was histologically confirmed by the presence of both endometrioid glands and stroma. Endometriosis was confirmed in 78 of the patients (51%). If the diagnostic criteria were extended also to include endometrioid stroma lacking glands, but containing iron pigment and/or hemorrhage, 82 patients (54%) were positive for endometriosis. Endometriosis was histologically confirmed in 76% of pigmented lesions, in 57% of clear or red papules, in 12% of peritoneal pockets, and in 16% when only fibrosis or scarring was observed. Half of the samples with confirmed endometriosis exhibited cyclic activity. The reproducibility of the histologic evaluation was satisfactory. A high rate of negative biopsies emphasizes the need of taking biopsies from peritoneal lesions suspected of endometriosis for confirmation of the diagnosis.
本研究的目的是比较怀疑为子宫内膜异位症的腹膜异常的宏观评估与组织的组织学检查结果。对152例因妇科问题接受检查（94例）或接受输卵管绝育术（58例）的患者，从宏观上异常的腹膜处获取腹膜活检组织，并检查是否存在子宫内膜异位症。子宫内膜异位症通过子宫内膜样腺体和间质的存在在组织学上得到证实。78例患者（51%）经组织学确诊为子宫内膜异位症。如果诊断标准扩大到也包括缺乏腺体但含有铁色素和/或出血的子宫内膜样间质，则82例患者（54%）子宫内膜异位症呈阳性。色素沉着病变中76%经组织学确诊为子宫内膜异位症，清亮或红色丘疹中57%确诊，腹膜陷凹中12%确诊，仅观察到纤维化或瘢痕形成时16%确诊。确诊为子宫内膜异位症的样本中有一半表现出周期性活动。组织学评估的可重复性令人满意。活检阴性率高强调了对怀疑为子宫内膜异位症的腹膜病变进行活检以确诊的必要性。
