Palmisano G P, Adamson G D, Lamb E J
Department of Gynecology and Obstetrics, Memorial Medical Center, Savannah, Georgia.
Int J Fertil Menopausal Stud. 1993 Jul-Aug;38(4):241-9.
Development of an endometriosis classification system based on empirically derived stages of the disease, to supplant the Acosta (1973), Kistner (1977), and American Fertility Society (1985) classifications, which are based on arbitrarily defined stages and often fail to predict pregnancy rates.
Retrospective cohort analysis.
University infertility clinic.
Women with endometriosis and > or = 1 year of infertility. Diagnosis of endometriosis was made by direct visualization, with type of lesion (implant or adhesion) at multiple sites recorded; total of 202 patients. All diagnosed infertility problems were treated based on semen analysis, postcoital test, and endometrial biopsy. Pregnancy rates were analyzed by life-table and cluster analyses, and combinations of site and type were also analyzed by Cox's regression model.
No individual anatomic site or type significantly affected prognosis, nor was any cluster useful for predicting outcome.
Anatomic site and type of lesion are insufficient for predicting fertility when used as sole components of a clinical staging system for endometriosis.
基于疾病经验性分期开发一种子宫内膜异位症分类系统，以取代阿科斯塔（1973年）、基斯特纳（1977年）以及美国生育协会（1985年）的分类系统，后三者基于任意定义的分期，且常常无法预测妊娠率。
回顾性队列分析。
大学不孕不育诊所。
患有子宫内膜异位症且不孕不育≥1年的女性。通过直接观察诊断子宫内膜异位症，记录多个部位的病变类型（植入物或粘连）；共202例患者。所有确诊的不孕问题均根据精液分析、性交后试验及子宫内膜活检进行治疗。采用寿命表法和聚类分析法分析妊娠率，同时通过考克斯回归模型分析部位和类型的组合情况。
没有单个解剖部位或类型对预后有显著影响，也没有任何聚类对预测结果有用。
当用作子宫内膜异位症临床分期系统的唯一组成部分时，解剖部位和病变类型不足以预测生育能力。
