Groothuis P G, Koks C A, de Goeij A F, Dunselman G A, Arends J W, Evers J L
Department of Pathology, Academic Hospital Maastricht and Maastricht University, The Netherlands.
Hum Reprod. 1998 Aug;13(8):2275-81. doi: 10.1093/humrep/13.8.2275.
One of the first steps in the pathogenesis of endometriosis is the attachment of the endometrium to the peritoneal lining. Since the peritoneum is extremely fragile and hard to obtain, amnion has been used as an in-vitro model to study adhesion. Scanning and transmission electron microscopy was applied to evaluate the adhesion of endometrial cells isolated in the proliferative and secretory phases of the menstrual cycle. Endometrial fragments obtained in either phase of the cycle were able to adhere to the extracellular matrix of the amnion. Fragments from proliferative phase endometrium showed active spreading and growth over the matrix surface, whereas fragments from secretory phase endometrium did not. Fragments from proliferative as well as secretory phase endometrium were able to adhere to the epithelial side of the amnion, but only at locations where the amniotic epithelium was damaged or partly absent. These observations indicate that the basement membrane and extracellular matrix provide a suitable substrate for endometrial cell attachment and growth and that endometrial cell adhesion occurs preferentially to subepithelial structures, whereas an intact epithelium prevents the adhesion of endometrial fragments to the amnion.
子宫内膜异位症发病机制的首要步骤之一是子宫内膜附着于腹膜。由于腹膜极其脆弱且难以获取，羊膜已被用作体外模型来研究粘连。应用扫描电子显微镜和透射电子显微镜来评估在月经周期增殖期和分泌期分离出的子宫内膜细胞的粘连情况。在月经周期任一阶段获取的子宫内膜碎片都能够附着于羊膜的细胞外基质。增殖期子宫内膜的碎片在基质表面呈现出活跃的铺展和生长，而分泌期子宫内膜的碎片则没有。增殖期和分泌期子宫内膜的碎片都能够附着于羊膜的上皮侧，但仅在羊膜上皮受损或部分缺失的部位。这些观察结果表明，基底膜和细胞外基质为子宫内膜细胞的附着和生长提供了合适的底物，并且子宫内膜细胞优先粘附于上皮下结构，而完整的上皮组织可防止子宫内膜碎片与羊膜粘连。
