Italian Endometriosis Foundation, Formello, Italy;
Italian Endometriosis Foundation, Formello, Italy.
In Vivo. 2022 Jan-Feb;36(1):430-438. doi: 10.21873/invivo.12721.
BACKGROUND/AIM: Endometriosis is a gynecological estrogen-dependent inflammatory disease due to ectopic endometrial tissue and often associated with pelvic pain. Despite its high prevalence, there are still uncertainties about its pathogenesis, diagnosis, and therapy.
This study presents a retrospective study conducted on 4,401 endometriosis patients, 584 of which underwent laparoscopic procedures. The archived data about clinical signs, magnetic resonance imaging (MRI) results, topography of the endometriosis lesions (obtained via laparoscopy) associated diseases, sample analysis and histological findings were analyzed. Next, the statistical associations between the information for each case, provided by these diagnostic tools were determined.
MRI is the most sensitive and specific diagnostic system for ovarian lesions, but poor in sensitivity and specificity for deep endometriosis lesions and not indicated for peritoneal lesions which remain the exclusive prerogative of laparoscopy. Clinical signs are essential for diagnosing deep lesions. The Ca125 and Ca19.9 markers have a poor reliability and their negativity in symptomatic patients has no clinical value, while in positive cases it could probably be used as a monitoring parameter.
The results generated will help provide an accurate picture of the topography and distribution of endometriotic lesions. Correlation analyses between the data generated by the clinical-instrumental examinations and those on the site of the disease identified by laparoscopy, allow to define the predictive value of the clinical-instrumental signs in the diagnosis and localization of endometriotic disease.
背景/目的：子宫内膜异位症是一种妇科雌激素依赖性炎症性疾病，由异位子宫内膜组织引起，常伴有盆腔疼痛。尽管其患病率很高，但对其发病机制、诊断和治疗仍存在不确定性。
本研究为回顾性研究，共纳入 4401 例子宫内膜异位症患者，其中 584 例行腹腔镜检查。分析了这些患者的临床体征、磁共振成像（MRI）结果、子宫内膜异位症病变的部位（腹腔镜下获得）、相关疾病、样本分析和组织学发现的存档数据。然后，确定了这些诊断工具提供的每个病例信息之间的统计关联。
MRI 是卵巢病变最敏感和最特异的诊断系统，但对深部子宫内膜异位症病变的敏感性和特异性较差，且不适合用于腹膜病变，而腹膜病变仍然是腹腔镜检查的唯一特权。临床体征对深部病变的诊断至关重要。CA125 和 CA19.9 标志物的可靠性较差，在有症状的患者中呈阴性无临床价值，而在阳性患者中可能可作为监测参数。
本研究结果将有助于提供子宫内膜异位症病变部位和分布的准确图像。对临床-仪器检查产生的数据与腹腔镜检查确定的疾病部位之间的相关性分析，可确定临床-仪器征象在子宫内膜异位症诊断和定位中的预测价值。
