Brosens I A
Leuven Institute for Fertility and Embryology, Belgium.
J Reprod Med. 1998 Mar;43(3 Suppl):281-6.
To explore the hypothesis that endometriosis is a disease not just because it exists but because it is functionally active.
Qualitative research analyzing the morphologic appearances of endometriosis and the clinical effect of medical therapies.
Analysis of the appearances of symptomatic endometriosis demonstrates that the ectopic endometriumlike tissue mimics eutopic endometrium but with loss of polarization. Ectopic implants resembling superficial endometrium are hemorrhagic and associated with adhesion and pseudocyst or endometrioma formation. Ectopic implants resembling basal or junction zone endometrium are associated with nodular adenomyotic lesions in the posterior fornix and pelvic supportive structures. They are characterized by smooth muscle hyperplasia and T-lymphocyte aggregates.
Medical therapy has been shown to be very efficient in reducing pelvic pain as soon as amenorrhea is created and maintained. Regression, but not elimination, of the implant is obtained by medical therapy. Clinical data support the hypothesis that the efficacy of medical therapy is largely achieved by preventing cyclic bleeding in the implants.
探讨子宫内膜异位症之所以是一种疾病，不仅是因为它存在，还因为它具有功能活性这一假说。
对子宫内膜异位症的形态学表现及药物治疗的临床效果进行定性研究。
对有症状的子宫内膜异位症表现的分析表明，异位的子宫内膜样组织模仿在位内膜，但失去了极性。类似浅表内膜的异位植入物会出血，并伴有粘连以及假囊肿或子宫内膜瘤形成。类似基底层或交界区内膜的异位植入物与后穹窿和盆腔支持结构中的结节性子宫腺肌病病变相关。它们的特征是平滑肌增生和T淋巴细胞聚集。
已证明药物治疗在一旦造成并维持闭经时，能非常有效地减轻盆腔疼痛。通过药物治疗可使植入物消退，但不能消除。临床数据支持这样的假说，即药物治疗的疗效很大程度上是通过防止植入物的周期性出血实现的。
