Signorile Pietro G, Baldi Feliciano, Bussani Rossana, D'Armiento Mariarosaria, De Falco Maria, Baldi Alfonso
Fondazione Italiana Endometriosi, Rome, Italy.
J Exp Clin Cancer Res. 2009 Apr 9;28(1):49. doi: 10.1186/1756-9966-28-49.
Endometriosis is a gynecological disease defined by the histological presence of endometrial glands and stroma outside the uterine cavity. Women with endometriosis have an increased risk of different types of malignancies, especially ovarian cancer and non-Hodgkin's lymphoma. Though there are several theories, researchers remain unsure as to the definitive cause of endometriosis. Our objective was to test the validity of the theory of müllerianosis for endometriosis, that is the misplacing of primitive endometrial tissue along the migratory pathway of foetal organogenesis
We have collected at autopsy 36 human female foetuses at different gestational age. We have performed a morphological and immunohistochemical study (expression of oestrogen receptor and CA125) on the pelvic organs of the 36 foetuses included en-block and totally analyzed.
In 4 out of 36 foetuses we found presence of misplaced endometrium in five different ectopic sites: in the recto-vaginal septum, in the proximity of the Douglas pouch, in the mesenchimal tissue close to the posterior wall of the uterus, in the rectal tube at the level of muscularis propria, and in the wall of the uterus. All these sites are common location of endometriosis in women.
We propose that a cause of endometriosis is the dislocation of primitive endometrial tissue outside the uterine cavity during organogenesis.
子宫内膜异位症是一种妇科疾病，其定义为子宫腔外存在子宫内膜腺体和间质的组织学表现。患有子宫内膜异位症的女性患不同类型恶性肿瘤的风险增加，尤其是卵巢癌和非霍奇金淋巴瘤。尽管有几种理论，但研究人员仍不确定子宫内膜异位症的确切病因。我们的目的是检验苗勒管异常学说对于子宫内膜异位症的有效性，即原始子宫内膜组织在胎儿器官发生的迁移途径中错位。
我们在尸检时收集了36例不同孕周的人类女性胎儿。我们对完整包含的36例胎儿的盆腔器官进行了形态学和免疫组织化学研究（雌激素受体和CA125的表达）并进行了全面分析。
在36例胎儿中的4例中，我们在五个不同的异位部位发现了错位的子宫内膜：直肠阴道隔、Douglas窝附近、子宫后壁附近的间充质组织、固有肌层水平的直肠管以及子宫壁。所有这些部位都是女性子宫内膜异位症的常见部位。
我们提出子宫内膜异位症的一个病因是在器官发生过程中原始子宫内膜组织在子宫腔外错位。
