Poordast Tahereh, Alborzi Saeed, Kiani Ziba, Omidifar Navid, Askary Elham, Chamanara Kefayat, Shokripour Mansoureh, Keshtvarz Hesam Abadi Alimohammad
Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Reprod Biomed. 2024 Sep 12;22(7):567-578. doi: 10.18502/ijrm.v22i7.16970. eCollection 2024 Jul.
The lack of improvement in some endometriotic people's pain after surgery even while using hormone treatment may suggest an inappropriate response to routine hormonal therapies.
This study aimed to determine a cut-off point for selecting the most appropriate treatment based on the hormone receptors of endometriotic lesions.
In this cross-sectional study, by reviewing the medical records of participants and testing their archive samples and phone interviews (if needed), 86 symptomatic women after endometriosis surgery who were operated into governmental hospitals, Shahid Faghihi and Hazrate Zeinab Shiraz Iran were enrolled between March 2017 and March 2019. Women were divided into 2 groups: responsiveness (n = 73 for dysmenorrhea, n = 60 for dyspareunia) to medical treatment and surgery, and unresponsiveness (n = 13, n = 7). We examined the pathological slides of 86 women to determine the amount of hormone receptors and the relationship between the type of medical treatment and the level of hormone receptors on pain relief within 1 yr after surgery.
Based on the receiver operating characteristic curve, dysmenorrhea in the presence of tissue estrogen receptors 60% (p = 0.1065), and dyspareunia in the presence of tissue progesterone receptors 80% (p = 0.0001) responded well to medical treatment after surgery. In the presence of endometrioma-dysmenorrhea showed the best response to oral contraceptive pills (69.4%), while in deep infiltrative endometriosis-dyspareunia showed the best response to progesterone treatment (75%).
Prescribing an appropriate hormone therapy based on a specific immunohistochemistry staining pattern can improve the life quality of postoperative endometriosis individuals.
一些子宫内膜异位症患者术后即使使用激素治疗，疼痛仍未改善，这可能表明对常规激素疗法反应不佳。
本研究旨在根据子宫内膜异位症病灶的激素受体确定一个选择最合适治疗方法的临界点。
在这项横断面研究中，通过查阅参与者的病历、检测其存档样本并进行电话访谈（如有需要），纳入了2017年3月至2019年3月期间在伊朗设拉子的沙希德·法吉希医院和哈兹拉特·泽伊纳布医院接受手术的86例有症状的子宫内膜异位症术后女性。将女性分为两组：对药物治疗和手术有反应（痛经组n = 73，性交困难组n = 60）和无反应（痛经组n = 13，性交困难组n = 7）。我们检查了86名女性的病理切片，以确定激素受体的数量以及药物治疗类型与术后1年内疼痛缓解的激素受体水平之间的关系。
根据受试者工作特征曲线，组织雌激素受体≥60%时痛经（p = 0.1065），组织孕激素受体≥80%时性交困难（p = 0.0001）对术后药物治疗反应良好。存在子宫内膜瘤时痛经对口服避孕药反应最佳（69.4%），而深部浸润性子宫内膜异位症时性交困难对孕激素治疗反应最佳（75%）。
根据特定的免疫组织化学染色模式开具适当的激素疗法可提高子宫内膜异位症术后患者的生活质量。
