Takahashi K, Eda Y, Abu-Musa A, Okada S, Yoshino K, Kitao M
Department of Obstetrics and Gynaecology, Shimane Medical University, Izumo, Japan.
Hum Reprod. 1994 Jul;9(7):1231-6. doi: 10.1093/oxfordjournals.humrep.a138684.
In order to investigate the pathological characteristics of polycystic ovaries diagnosed by transvaginal ultrasound (TVS) in patients with polycystic ovarian syndrome (PCOS) and to investigate the relationship between morphological and endocrine changes in the ovaries, 32 PCOS patients with bilateral polycystic ovaries (> 10 cysts) detected by TVS were studied; 20 ovulatory women served as controls. Ovarian tissues from wedge resection were examined histologically. A comparative histological and TVS study of ovarian morphology was made, and the relationship between the number of small cysts and the endocrine profile was examined. The position and size of small cysts on TVS agreed with those observed histologically. There was a significant correlation between the number of small cysts on TVS and the number of atretic follicles with hypertrophied and luteinized inner theca cells, and thickened ovarian capsules. Numerous atretic follicles and thickened ovarian capsules were observed in 97 and 64% of ovaries respectively, from PCOS patients. In patients with PCOS, a significant positive correlation was noted both between the number of small cysts and delta 4-androstenedione (ASD), and between ASD and the luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio. Furthermore, testosterone, ASD and the number of small cysts on TVS were significantly higher in PCOS patients with ovarian thickened tunica compared to PCOS patients without ovarian thickened tunica. TVS images of ovaries in patients with PCOS correlated with the histopathological and endocrine features. It is suggested that an increase in intra-ovarian small cysts leads to increased production of ovarian androgen, in turn influencing the secretion of gonadotrophin, and is correlated with ovarian capsular thickness.
为了研究经阴道超声（TVS）诊断的多囊卵巢综合征（PCOS）患者多囊卵巢的病理特征，并探讨卵巢形态与内分泌变化之间的关系，对32例经TVS检测出双侧多囊卵巢（囊肿>10个）的PCOS患者进行了研究；20例排卵正常的女性作为对照。对楔形切除的卵巢组织进行组织学检查。对卵巢形态进行了组织学和TVS对比研究，并检查了小囊肿数量与内分泌特征之间的关系。TVS上小囊肿的位置和大小与组织学观察结果一致。TVS上小囊肿的数量与伴有肥大和黄素化内膜细胞的闭锁卵泡数量以及卵巢包膜增厚之间存在显著相关性。分别在97%和64%的PCOS患者卵巢中观察到大量闭锁卵泡和卵巢包膜增厚。在PCOS患者中，小囊肿数量与δ4-雄烯二酮（ASD）之间以及ASD与黄体生成素/卵泡刺激素（LH/FSH）比值之间均存在显著正相关。此外，与无卵巢包膜增厚的PCOS患者相比，有卵巢包膜增厚的PCOS患者的睾酮、ASD和TVS上小囊肿的数量显著更高。PCOS患者卵巢的TVS图像与组织病理学和内分泌特征相关。提示卵巢内小囊肿增多导致卵巢雄激素生成增加，进而影响促性腺激素的分泌，并与卵巢包膜厚度相关。
