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深部子宫内膜异位症。肠道部位的临床、组织病理学及共聚焦显微镜检查相关性

Deep endometriosis. Clinical, histopathological and confocal microscopy correlations in intestinal sites.

作者信息

Berbecaru Elena Iuliana Anamaria, Zorilă George Lucian, Istrate-Ofiţeru Anca Maria, Pirici Daniel, Donoiu Andreas, Creţu Oana Iulia, Roşu Gabriela Camelia, Brătilă Elvira, Miron Dumitra, Mateescu Valentin Octavian, Negroiu Cristina Elena, Dănoiu Suzana, Iliescu Dominic Gabriel, Tudoraşcu Robertina Iulia

机构信息

Department of Histology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania;

出版信息

Rom J Morphol Embryol. 2025 Jan-Mar;66(1):137-151. doi: 10.47162/RJME.66.1.13.

DOI:10.47162/RJME.66.1.13
PMID:40384200
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12236285/
Abstract

Intestinal endometriosis (IE), a chronic condition affecting a notable percentage of women with endometriosis (estimates varying from roughly 4% to 37%) and can impact any part of the intestine, but it most frequently involves the rectum and sigmoid colon. This is a retrospective study that included 178 women diagnosed with this condition that were investigated taking into consideration the symptoms, diagnostic approaches, surgical treatments, and detailed features of the intestinal wall, including the behavior and quantity of interstitial cells of Cajal (ICC) correlated with the symptomatology experienced. We were able to highlight the most common symptoms such as pelvic pain and bowel disorders. The rectum was identified as the most commonly affected intestinal segment. Transvaginal ultrasound can be valuable in assessing IE, improving preoperative diagnosis and treatment strategies. Laparoscopic surgery remains the definitive diagnostic method, allowing direct visualization and excision of lesions. Surgical technique selections are complex and require careful consideration tailored to each patient. A reduction in ICC numbers may disrupt gut motility, emphasizing their importance in maintaining normal intestinal function, a factor particularly relevant in endometriosis where disruption of ICC networks can contribute to gastrointestinal dysfunction.

摘要

肠道子宫内膜异位症(IE)是一种慢性病,影响着相当比例的子宫内膜异位症女性患者(估计比例约为4%至37%),可累及肠道的任何部位,但最常累及直肠和乙状结肠。这是一项回顾性研究,纳入了178例被诊断为此病的女性患者,研究考虑了症状、诊断方法、手术治疗以及肠壁的详细特征,包括与所经历症状相关的 Cajal 间质细胞(ICC)的行为和数量。我们能够突出最常见的症状,如盆腔疼痛和肠道紊乱。直肠被确定为最常受累的肠段。经阴道超声在评估IE方面可能很有价值,有助于改善术前诊断和治疗策略。腹腔镜手术仍然是确诊的诊断方法,可直接观察并切除病变。手术技术的选择很复杂,需要根据每个患者的情况仔细考虑。ICC数量的减少可能会扰乱肠道蠕动,这凸显了它们在维持正常肠道功能中的重要性,这一因素在子宫内膜异位症中尤为相关,因为ICC网络的破坏可能导致胃肠功能障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/a51ce9bea889/RJME-66-1-137-fig12.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/a51ce9bea889/RJME-66-1-137-fig12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/1b2d67724945/RJME-66-1-137-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/2e7386652bff/RJME-66-1-137-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/ee958cf81ff6/RJME-66-1-137-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/07481b6493cf/RJME-66-1-137-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/6c424d594d7e/RJME-66-1-137-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/0f7f03966e53/RJME-66-1-137-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/f2a09c0228a2/RJME-66-1-137-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/dce7fc4d0d22/RJME-66-1-137-fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/2ab062777dda/RJME-66-1-137-fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/3b3eb1fac6d4/RJME-66-1-137-fig10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/aad1a4240254/RJME-66-1-137-fig11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c5/12236285/a51ce9bea889/RJME-66-1-137-fig12.jpg

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本文引用的文献

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Acta Obstet Gynecol Scand. 2024 Sep;103(9):1764-1770. doi: 10.1111/aogs.14921. Epub 2024 Jul 22.
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Non-invasive imaging techniques for diagnosis of pelvic deep endometriosis and endometriosis classification systems: an International Consensus Statement.用于盆腔深部子宫内膜异位症诊断和子宫内膜异位症分类系统的非侵入性成像技术:国际共识声明。
Ultrasound Obstet Gynecol. 2024 Jul;64(1):129-144. doi: 10.1002/uog.27560. Epub 2024 May 29.
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Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression.
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Int J Mol Sci. 2024 Feb 1;25(3):1789. doi: 10.3390/ijms25031789.
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Appendiceal Endometriosis: A Comprehensive Review of the Literature.阑尾子宫内膜异位症:文献综述
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