Benagiano Giuseppe, Brosens Ivo, Lippi Donatella
Department of Gynaecology, Obstetrics and Urology, Sapienza University, Rome, Italy.
Gynecol Obstet Invest. 2014;78(1):1-9. doi: 10.1159/000358919. Epub 2014 May 16.
A dispute has recently emerged whether early descriptions exist of the condition we name endometriosis. A first question is: 'Who identified endometriosis?' To respond, two non-complementary methods have been employed: searching for ancient descriptions of symptoms associated with endometriosis or, alternatively, identifying researchers who described pathological features we associate with the presence of endometriosis in its various forms. We opted for the latter and found no evidence that in older times anyone delineated the macroscopic features of endometriosis; descriptions of menstrual or cyclic pain cannot be taken as proof of knowledge of what caused it. During the mid-part of the 19th century, Rokitansky had a great intuition: endometrial glands and stroma can be present in ovarian and uterine neoplasias. However, using histological parameters of endometrial structure and activity, the first scientist to delineate peritoneal endometriosis under the name 'adenomyoma' was Cullen. On the other hand, Rokitansky was the first to describe a form of adenomyosis (an adenomatous polyp). Early descriptions of ovarian endometrioma as 'haematomas of the ovary' or 'chocolate cysts' date back to the end of the 19th century. The first mention of an 'ovary containing uterine mucosa' was published in 1899 by Russel, but Sampson was the first to demonstrate specific endometrial activities, such as desquamation at the time of menstruation and decidualization in pregnancy; subsequently, he presented a theory on its pathogenesis.
最近出现了一场争论，即是否存在对我们现在称为子宫内膜异位症这种病症的早期描述。第一个问题是：“谁发现了子宫内膜异位症？”为了回答这个问题，人们采用了两种并非相互补充的方法：一是寻找与子宫内膜异位症相关症状的古代描述，另一种是找出那些描述了我们认为与各种形式的子宫内膜异位症存在相关的病理特征的研究人员。我们选择了后者，但没有发现证据表明在过去有任何人描绘过子宫内膜异位症的宏观特征；对月经疼痛或周期性疼痛的描述不能被视为知晓其病因的证据。在19世纪中叶，罗基坦斯基有一个伟大的直觉：子宫内膜腺体和间质可能存在于卵巢和子宫肿瘤中。然而，根据子宫内膜结构和活性的组织学参数，第一个以“腺肌瘤”之名描绘腹膜子宫内膜异位症的科学家是卡伦。另一方面，罗基坦斯基是第一个描述一种子宫腺肌病形式（一种腺瘤性息肉）的人。卵巢子宫内膜异位囊肿早期被描述为“卵巢血肿”或“巧克力囊肿”，可追溯到19世纪末。1899年，拉塞尔首次提到“含有子宫黏膜的卵巢”，但桑普森是第一个证明特定子宫内膜活动的人，比如月经时的脱屑和孕期的蜕膜化；随后，他提出了关于其发病机制的理论。
