FSAEI HE "Peoples' Friendship University of Russia", Moscow, Russia.
City Clinical Hospital Named V. V. Vinogradov, Moscow, Russia.
Gynecol Endocrinol. 2020;36(sup1):20-23. doi: 10.1080/09513590.2020.1816723.
The aim of the study was to expand the understanding of pathogenesis of adenomyosis-associated pelvic pain.
We studied 30 (n = 30) biopsy samples obtained after hysterectomy in women with diffuse adenomyosis of grade II-III, accompanied by severe pain syndrome, who did not receive hormonal therapy. The morphologic comparison group comprised 30 (n = 30) biopsy samples obtained from women with adenomyosis, without pain syndrome, operated on for abnormal uterine bleeding, who also did not receive hormone therapy.
The total density of immunological OTR labeling in the adenomyotic lesion foci was 73.7 ± 1.8%, and in the morphological control group it was 35.2 ± 1.4% (p <0.05), which indicates a significant effect of oxytocin as a ureterotonic peptide. Processes of local neurogenesis and growth of nerve fibers was established due to an increase in the expression of the nervous system growth factor NGF in the myometrium stroma, in comparison with biopsy samples of morphological control.
Pelvic pain pathogenesis in women with diffuse adenomyosis compared with the painless form of the disease is an increase in the activity of ureterotonic factors of OTR oxytocin. Compared to the painless form of adenomyosis, the myometrial innervation apparatus of patients with pelvic pain is characterized by a significantly higher expression of nerve growth factor.
本研究旨在深入了解子宫腺肌病相关盆腔疼痛的发病机制。
我们研究了 30 例（n=30）因弥漫性 II-III 级子宫腺肌病伴严重疼痛综合征而接受子宫切除术的患者的活检样本，这些患者未接受激素治疗。形态学比较组包括 30 例（n=30）因异常子宫出血而接受手术且未接受激素治疗的无疼痛综合征的腺肌病患者的活检样本。
在腺肌病病灶中，免疫性 OTR 标记的总密度为 73.7±1.8%，而在形态学对照组中为 35.2±1.4%（p<0.05），这表明催产素作为一种输尿管收缩肽具有显著作用。由于神经生长因子 NGF 在子宫肌层中的表达增加，导致局部神经发生和神经纤维生长过程增加。
与无痛型疾病相比，弥漫性子宫腺肌病患者的盆腔疼痛发病机制是 OTR 催产素的输尿管收缩因子活性增加。与无痛型腺肌病相比，盆腔疼痛患者的子宫肌层支配装置的神经生长因子表达明显更高。
