Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA, United States of America.
Division of Gynecologic Oncology, Baylor College of Medicine, Houston, TX, United States of America.
PLoS One. 2020 May 13;15(5):e0232487. doi: 10.1371/journal.pone.0232487. eCollection 2020.
Endosalpingiosis, traditionally regarded as an incidental pathological finding, was recently reported to have an association with gynecologic malignancies. To determine the prevalence of endosalpingiosis, we evaluated all benign appearing adnexal lesions using the Sectioning and Extensively Examining-Fimbria (SEE-Fim) protocol, and queried the pathology database for the presence of endosalpingiosis, gynecologic malignancy, endometriosis, Walthard nests, and paratubal cysts. Using the SEE-Fim protocol, the prevalence of endosalpingiosis, endometriosis, Walthard nests, and paratubal cysts were 22%, 45%, 33%, and 42% respectively, substantially higher than previously reported. All lesions were observed to increase with age except endometriosis which increased until menopause then decreased dramatically. Among specimens including ovarian tissue, the prevalence of implantation of at least one lesion type was ubiquitous in patients age 51 and older (93%). The clinical significance of endosalpingiosis should be a continued area of research with larger trials assessing prevalence, factors affecting incidence, and association with malignancy. Our findings contribute to elucidating the origin of ectopic lesions and gynecologic disease risk.
子宫内膜化生，传统上被认为是一种偶发的病理发现，最近有报道称其与妇科恶性肿瘤有关。为了确定子宫内膜化生的患病率，我们使用切片和广泛检查输卵管伞端（SEE-Fim）方案评估了所有良性附件病变，并在病理数据库中查询了子宫内膜化生、妇科恶性肿瘤、子宫内膜异位症、Walthard 巢和副输卵管囊肿的存在情况。使用 SEE-Fim 方案，子宫内膜化生、子宫内膜异位症、Walthard 巢和副输卵管囊肿的患病率分别为 22%、45%、33%和 42%，明显高于之前的报道。除了子宫内膜异位症，所有病变都随着年龄的增长而增加，子宫内膜异位症在绝经前增加，然后急剧减少。在包括卵巢组织在内的标本中，至少有一种病变类型的植入在 51 岁及以上的患者中普遍存在（93%）。子宫内膜化生的临床意义应该是一个持续的研究领域，需要更大的试验来评估患病率、影响发病率的因素以及与恶性肿瘤的关系。我们的发现有助于阐明异位病变和妇科疾病风险的起源。
