Nisolle M, Casanas-Roux F, Anaf V, Mine J M, Donnez J
Department of Gynecology, Catholic University of Louvain, Brussels, Belgium.
Fertil Steril. 1993 Mar;59(3):681-4.
To evaluate the stromal vascularization of different appearances of peritoneal endometriosis, biopsies were taken from peritoneal areas with endometriosis in a series of 135 infertile women and classified as typical (black), red, or white lesions. The number of capillaries per mm2 of stroma, their mean surface area, and the ratio of capillaries/stroma surface area, and the mitotic activity were analyzed in typical, red, and white lesions. Significant differences were found between the different subgroups. The higher vascularization and mitotic activity observed in red lesions suggested the hypothesis that such lesions are very active and probably the first stage of early implantation of endometrial glands and stroma. The poor vascularization and the absence of mitosis observed in white lesions suggested that these lesions are much less active than red lesions and are a quiescent stage of the disease. Our study proves that the "activity" of peritoneal endometriosis is related to the vascularity. This concept must be considered in the further discussion of American Fertility Society Endometriosis Classification. Typical, red and white lesions are three different stages of the peritoneal disease and their relative relation to infertility is also probably different.
为评估不同外观的腹膜子宫内膜异位症的间质血管化情况，在135例不孕妇女中，从有子宫内膜异位症的腹膜区域取活检组织，并将其分为典型（黑色）、红色或白色病变。分析典型、红色和白色病变中每平方毫米间质内的毛细血管数量、其平均表面积、毛细血管/间质表面积比值以及有丝分裂活性。在不同亚组之间发现了显著差异。在红色病变中观察到的较高血管化和有丝分裂活性提示了这样一种假说，即此类病变非常活跃，可能是子宫内膜腺体和间质早期植入的第一阶段。在白色病变中观察到的血管化不良和无有丝分裂现象提示这些病变的活性远低于红色病变，是疾病的静止阶段。我们的研究证明，腹膜子宫内膜异位症的“活性”与血管化有关。在美国生育协会子宫内膜异位症分类的进一步讨论中必须考虑这一概念。典型、红色和白色病变是腹膜疾病的三个不同阶段，它们与不孕的相对关系可能也不同。
