Viscomi Francesco Antonio, Dias Rogério, De Luca Laurival, Franco Marcello Fabiano de, Ihlenfeld Mauro Fernando Kürten
Instituto Vascomi, Ginecologia Minimamente Invasiva, São Paulo, SP.
Rev Assoc Med Bras (1992). 2004 Jul-Sep;50(3):344-8. doi: 10.1590/s0104-42302004000300046. Epub 2004 Oct 21.
To evaluate the correlation between laparoscopic aspects and glandular hystological findings of peritoneal endometriosis to understand the theory of evolution of endometriosis.
Sixty seven women with peritoneal endometriosis were submitted to laparoscopy. Peritoneal biopsy was taken from the typical (puckered black) and atypical endometriotic implants. The different aspects of endometriosis were classified as follows: red lesions (group V), black lesions (group N) and white lesions (group B). Hystological sections were examined according to a standardized protocol. The hystological parameters used were: functional characteristics of glandular epithelium, presence of intraluminal debris, occurrence of mitosis and stroma/gland ratio.
Functional characteristics of glandular epithelium showed statistically significant association among groups. Secretory epithelium was found in 68.4 % of group V, in 15.8% of groups N & B, while not characteristic epithelium was found in 19.4% of red lesions, 38.7% of black lesions and 41.9% of white lesions. Proliferative epithelium was found in 50% of group B patients and in 25% of groups V & N (p=0.011). Regarding intraluminal debris, there were also statistically significant differences among the groups, present in 58.4% of group N, 33.3% of group B and 8.3% of group V (p=0.016). There was no statistical difference between occurrence of mitosis (P=0.428), nor in the stroma/gland ratio (p=0.159).
Association between functional activity and red lesions and low activity in black and white lesions, regarding the hystological characteristics of the glandular epithelium analyzed in this study shows the importance of the theory of evolution of endometriosis. This was also demonstrated by presence of intraluminal debris in the study groups.
评估腹腔镜检查结果与腹膜子宫内膜异位症腺体组织学表现之间的相关性，以了解子宫内膜异位症的演变理论。
67例腹膜子宫内膜异位症患者接受了腹腔镜检查。从典型（皱缩黑色）和非典型子宫内膜异位植入物处获取腹膜活检组织。子宫内膜异位症的不同表现分类如下：红色病变（V组）、黑色病变（N组）和白色病变（B组）。组织学切片按照标准化方案进行检查。所使用的组织学参数包括：腺上皮的功能特征、管腔内碎片的存在情况、有丝分裂的发生情况以及间质/腺体比例。
腺上皮的功能特征在各组之间显示出统计学上的显著关联。在V组中，68.4%发现分泌上皮，在N组和B组中分别为15.8%，而在19.4%的红色病变、38.7%的黑色病变和41.9%的白色病变中发现非特征性上皮。在B组患者中50%发现增殖上皮，在V组和N组中为25%（p = 0.011）。关于管腔内碎片，各组之间也存在统计学上的显著差异，N组中为58.4%，B组中为33.3%，V组中为8.3%（p = 0.016）。有丝分裂的发生率（P = 0.428）以及间质/腺体比例（p = 0.159）之间无统计学差异。
本研究分析的腺上皮组织学特征表明，功能活性与红色病变相关，而黑色和白色病变活性较低，这显示了子宫内膜异位症演变理论的重要性。研究组中管腔内碎片的存在也证明了这一点。
