Faculté de Médecine, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Universitaire Ouest, Centre Hospitalier, Paris, France.
Fertil Steril. 2011 Mar 1;95(3):877-81. doi: 10.1016/j.fertnstert.2010.10.027. Epub 2010 Nov 11.
To investigate whether the clinical history, particularly of the adolescence period, contains markers of deeply infiltrating endometriosis (DIE).
Cross-sectional study.
Universitary tertiary referral center.
PATIENT(S): Two hundred twenty-nine patients operated on for endometriosis. Endometriotic lesions were histologically confirmed as non-DIE (superficial peritoneal endometriosis and/or ovarian endometriomas) (n = 131) or DIE (n = 98).
INTERVENTION(S): Surgical excision of endometriotic lesions with pathological analysis of each specimens.
MAIN OUTCOME MEASURE(S): Epidemiological data, pelvic pain scores, family history of endometriosis, absenteeism from school during menstruation, oral contraceptive (OC) pill use.
RESULT(S): Patients with DIE had significantly more positive family history of endometriosis (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.2-8.8) and more absenteeism from school during menstruation (OR = 1.7; 95% CI: 1-3). The OC pill use for treating severe primary dysmenorrhea was more frequent in patients with DIE (OR = 4.5; 95% CI: 1.9-10.4). Duration of OC pill use for severe primary dysmenorrhea was longer in patients with DIE (8.4 ± 4.7 years vs. 5.1 ± 3.8 years). There was a higher incidence of OC pill use for severe primary dysmenorrhea before 18 years of age in patients with DIE (OR = 4.2; 95% CI: 1.8-10.0).
CONCLUSION(S): The knowledge of adolescent period history can identify markers that are associated with DIE in patients undergoing surgery for endometriosis.
探讨临床病史,特别是青春期病史,是否包含深部浸润性子宫内膜异位症(DIE)的标志物。
横断面研究。
大学附属医院。
229 例因子宫内膜异位症而行手术治疗的患者。通过组织病理学分析,将子宫内膜异位症病灶分为非 DIE(腹膜表面子宫内膜异位症和/或卵巢子宫内膜异位囊肿)(n=131)或 DIE(n=98)。
切除子宫内膜异位症病灶,并对每个标本进行病理分析。
流行病学数据、盆腔疼痛评分、子宫内膜异位症家族史、经期缺课、口服避孕药(OC)使用情况。
DIE 患者的子宫内膜异位症家族史阳性率显著更高(比值比[OR] = 3.2;95%置信区间[CI]:1.2-8.8),经期缺课率也更高(OR = 1.7;95% CI:1-3)。为治疗严重原发性痛经而使用 OC 避孕药的患者中,DIE 患者更为常见(OR = 4.5;95% CI:1.9-10.4)。DIE 患者因严重原发性痛经而使用 OC 避孕药的时间更长(8.4±4.7 年 vs. 5.1±3.8 年)。在 18 岁之前,为治疗严重原发性痛经而使用 OC 避孕药的患者中,DIE 患者的发生率更高(OR = 4.2;95% CI:1.8-10.0)。
了解青春期病史可以识别出与行子宫内膜异位症手术的患者的 DIE 相关的标志物。