Makiyan Zograb
a Department of Operative Gynaecology , Federal State Scientific Centre of Obstetrics, Gynaecology and Perinatology after V.I. Kulakov , Moscow , Russia.
Organogenesis. 2017 Jul 3;13(3):95-102. doi: 10.1080/15476278.2017.1323162. Epub 2017 May 9.
Endometriosis is defined by the presence of endometrial ectopia. Multiple hypotheses have been postulated to explain the etiology of endometriosis to understand various clinical evidences. The etiology of endometriosis is still unclear.The primary question to understanding the etiology of endometrial ectopia (endometriosis) is determining the origin of eutopic (normally cited) endometrium.According to the new theory, primordial germ cells migrate from hypoblast (yolk sac close to the allantois) to the gonadal ridges. The gonadal ridges which composed of primordial germ cells derive to the: eutopic endometrium, ovary, ovarian ligament and ligamentum teres uteri.There are 2 principal processes in uterine organogenesis: the intersection of gonadal ridges with mesonephral ducts to form the uterine folds with an endometrial cavity and the fusion of the both uterine folds together to form the unicavital (normal) uterus. In the uterine folds there are closer cell-to-cell communications, polypotential germ cells differentiate and grow into myometrium and endometrial layers.Some of the polypotential germ cells fail to reach the ridges and stay in the peritoneal cavity, where they may be transforming into external endometrial heterotopies.The main insight in the etiology of endometriosis is polypotential germ cells origin, which may explain its potency, pathogenesis and expansion.
子宫内膜异位症由子宫内膜异位灶的存在所定义。人们提出了多种假说来解释子宫内膜异位症的病因,以理解各种临床证据。子宫内膜异位症的病因仍不清楚。理解子宫内膜异位灶(子宫内膜异位症)病因的首要问题是确定在位(通常所说的)子宫内膜的起源。根据新理论,原始生殖细胞从内胚层(靠近尿囊的卵黄囊)迁移至生殖嵴。由原始生殖细胞组成的生殖嵴衍生出:在位子宫内膜、卵巢、卵巢韧带和子宫圆韧带。子宫器官发生过程中有两个主要过程:生殖嵴与中肾管相交形成带有子宫内膜腔的子宫褶,以及两个子宫褶融合在一起形成单腔(正常)子宫。在子宫褶中存在更紧密的细胞间通讯,多能生殖细胞分化并生长为肌层和子宫内膜层。一些多能生殖细胞未能到达生殖嵴并留在腹膜腔,在那里它们可能转化为外在性子宫内膜异位灶。子宫内膜异位症病因的主要观点是多能生殖细胞起源,这可能解释其潜能、发病机制和扩展。