SEARCH · PubMed Health

Results for “ENDOMETRIOSIS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources

PubMed2001

[VEGF concentration in peritoneal fluid of patients with endometriosis].

The theory of Sampson that endometrial cells and fragments desquamated during the menstrual period are transported through fallopian tubes into the peritoneal cavity where they implant, proliferate and develop into endometriotic lesions is generally accepted. There is increasing evidence that immunological mechanisms play a role in the pathogenesis and pathophysiology of endometriosis. Excessive endometrial angiogenesis is proposed as an important mechanism in the pathogenesis of endometriosis. Evidence is reviewed for the hypothesis that the endometrium of women with endometriosis has an increased capacity to proliferate, implant and grow in the peritoneal cavity. From the known angiogenic factors, vascular endothelial growth factor (VEGF) has emerged as a pivotally important regulator of normal angiogenesis and pathological neovascularization. In present study we evaluated the concentrations of VEGF in peritoneal fluid of patients with endometriosis and showed no correlation between AFS score and VEGF concentration in peritoneal and in ovarian endometriosis. Above results do not confirm former observations indicating the role of VEGF in endometriosis pathogenesis.

Adult↗

PubMed2001

[Clinicopathological features of malignant ovarian neoplasms arising from ovarian endometriosis: a report of 26 cases].

OBJECTIVE: To clarify the features of malignant ovarian neoplasms arising from ovarian endometriosis. METHODS: A total of 26 women with malignant ovarian neoplasms arising from ovarian endometriosis were analyzed retrospectively. RESULTS: Dysmenorrhea and pelvic mass were the most common clinical features. Among 18 cases who underwent B-ultrasound or color doppler ultrasound examination, solid foci in the pelvic masses were found in 10 cases. The main histologic types of ovarian malignancy were endometrioid adenocarcinoma and clear cell carcinoma. Microscopically atypical endometriosis with the tumors were found in 15 cases. International Federation of Gynecology and Obstetrics stage: stage I 21(81%) cases, stage II 3(12%) cases, stage III 2 (8%) cases. CONCLUSIONS: Clinical diagnosis of malignant ovarian neoplasms arising from ovarian endometriosis in early stage is difficult, and B-ultrasound examination is more valuable for diagnosis. It is suggested that close serutiny of endometrial hyperplasia, cellular atypia and malignancy in ovarian endometriosis be essential to understand the origin and development of malignant neoplasms arising from ovarian endometriosis.

Adult↗

PubMed2001

[Expression of human leucocyte antigen in ectopic endometrial tissue of endometriosis].

OBJECTIVE: To investigate the human leucocyte antigen (HLA) expression of ectopic endometrial epithelial cells in cases with endometriosis and its role in pathogenesis of endometriosis. METHODS: By immunohistochemical analysis, HLA expression was observed in ectopic endometrial epithelial cells of 25 endometriosis patients. Ectopic endometrial cells were cultured in vitro successfully and the expression of HLA were analyzed by flow cytometry in 10 out of the 25 patients. Eutopic endometrium of 15 normal women were taken as control. RESULTS: (1) Expression of HLA class I molecule on ectopic endometrial epithelial cells of endometriosis measured by the immunohistochemical analysis was lower than those of controls, (4.0 +/- 0.5) score and (1.2 +/- 0.8) score respectively. So was the expression rate by flow cytometry in vitro culture (63.38 +/- 11.88)% and (5.27 +/- 2.88)% respectively (P < 0.01). (2) The expression of HLA class II molecule on ectopic endometrial epithelial cells of endometriosis was significantly increased. The outcome by immunohistochemical analysis was (0.2 +/- 0.1) score (control group) and (4.1 +/- 0.7) score (case group) and by flow cytometry was (7.19 +/- 2.43)% and (58.57 +/- 14.99)% respectively (P < 0.01). CONCLUSIONS: The abnormal HLA expression could play a role in the pathogenesis of endometriosis.

Adult↗

PubMed2002

[Comparative study of HLA-DQA1 and HLA-DRB1 allele in patients with endometriosis and adenomyosis].

OBJECTIVE: To make a comparative study of HLA-DQA1 and HLA-DRB1 allele frequencies in the cases of endometriosis and adeonmyosis. METHODS: The allelic types of HLA-DQA1 and HLA-DRB1 were detected by polymerase chain reaction-sequence specific primers (PCR-SSP) technique in 51 cases of endometriosis, 45 cases of adenomyosis, and 44 normal individuals as the control. RESULTS: The frequencies of HLA-DQA1*0401(7.8%, 10.0%) were significantly increased in the endometriosis group and the adenomyosis group (Pc=0.03, Pc=0.01), and the frequencies of HLA-DQA1*0301(8.8%, 5.6%) were significantly decreased in these two groups (Pc=0.00, Pc=0.00).There was no significant difference between the frequencies of HLA-DQA1 and HLA-DRB1 of endometriosis and adenomyosis. CONCLUSION: The results indicate that HLA-DQA1*0301 and *0401 alleles are associated with both endometriosis and adenomyosis, and there is perhaps common mechanism involved in both endometriosis and adenomyosis based on HLA-DQA1 and HLA-DRB1 allele frequencies.

Asian People↗

PubMed2001

[The malignant potential of ovarian atypical endometriosis].

OBJECTIVE: To investigate the malignant potential of ovarian atypical endometriosis and ovarian endometrioid adenocarcinoma. METHODS: 12 cases of ovarian endometroid adenocarcinoma with associated endometriosis were reviewed retrospectively. Microsatellite markers were used to detect the loss of heterozygosity on chromosome 10q23 in ovarian carcinoma and their coexisting endometriosis. RESULTS: Among the 12 cases, benign eosinophilic metaplasia was observed in 8 cases, 5 of which (41.7%) with atypia. In these 5 cases, a spectrum of benign-atypical endometriosis with a transition to endometrioid adenocarcinoma was identified, and common genetic lesions were also detected in 2 of the 5 atypical endometriosis and their coexisting carcinomas. CONCLUSION: Histological observations as well as the molecular genetic evidence indicate that ovarian atypical endometriosis may possess a precancerous potential or play a role in the pathogenesis of certain malignant ovarian cancers.

Adenocarcinoma↗

PubMed2002

Chemokine growth-regulated-alpha: a possible role in the pathogenesis of endometriosis.

Endometriosis is a common disease in women at reproductive age. We investigated the concentration of neutrophil-activating factor (growth-regulated gene-alpha; GRO-alpha) (a member of the chemokine family), in peritoneal fluid of infertile women with or without endometriosis. Peritoneal fluid was obtained laparoscopically from 22 women with and 21 without visible endometriotic lesions. GRO-alpha concentration was measured by the use of an ELISA kit. Median concentration of GRO-alpha was 87.65 +/- 56.19 pg/ml in the study group and 60.72 +/- 11.98 pg/ml in the control group. The distribution of data differed from normal, therefore logarithmic transformation of data was performed. Concentration of GRO-alpha was significantly higher in the peritoneal fluid of women with endometriosis when compared with controls (p = 0.05). No correlation between concentration of GRO-alpha, stage of endometriosis, duration of infertility or sex steroid hormone levels was found. The study shows that GRO-alpha may play a role in the pathogenesis of endometriosis, possibly by chemoattraction and activation of neutrophils present in higher numbers in the peritoneal fluid of women with endometriosis. It is also feasible that the angiogenic properties of GRO-alpha might prompt the progression of endometriotic lesions.

Adult↗

PubMed2002

Expression of metalloproteinase-9 in ectopic endometrium in women with endometriosis.

OBJECTIVE: To study the expression of matrix metalloproteinase-9 (MMP-9) in ectopic and eutopic endometrium from women with endometriosis, thereby to determine the role of matrix metalloproteinases in the pathogenesis of endometriosis. METHODS: Both ectopic and eutopic endometrium tissue specimens were obtained from 30 women with endometriosis, and gelatinase activity in the specimens was detected by zymography and quantitated by Gel Documentation Analysis System. RESULTS: MMP-9 was detected in both eutopic and ectopic endometrium, but the latter contained higher levels of MMP-9 than the former did, and as the endometriosis worsened, MMP-9 expression tended to increase further. CONCLUSION: Endometriotic tissue possesses higher level of gelatinase activity than eutopic endometrium from patients with endometriosis does, and MMP-9 might be of importance for the implantation and invasive growth of endometriotic tissue that may lead to endometriosis.

Electrophoresis, Polyacrylamide Gel↗

PubMedDate not supplied

Accuracy of laparoscopic diagnosis of endometriosis.

BACKGROUND AND OBJECTIVE: Laparoscopy is the standard method to visually identify endometriotic lesions under magnification within and outside the minor pelvis. The aim of this study was to analyze the accuracy of laparoscopic visualization in diagnosing the various endometriotic sites as confirmed histologically. METHOD: Presumed endometriotic sites were observed in 164 patients operated on under the clinical suspicion of endometriosis. Targeted biopsies were performed for histologic corroboration, comparing the laparoscopic findings and diagnosis to the histological results. RESULT: The histological reports of the biopsies confirmed the presence of endometriosis in 138 patients (84.1%), but in 26 patients (15.9%), no evidence of endometriosis was observed. 100% of "red" lesions, 92% of "black" lesions, and 31% of "white" lesions turned out to be endometriosis. Of the 264 various suspected endometriotic sites observed, 142 (53.8%) were confirmed histologically. The most accurate diagnosis was in lesions on the parietal peritoneum of the pelvis, confirmed in 9/9 cases (100%); the ovarian fossa, confirmed in 8/12 cases (66.7%); and the uterosacral ligaments and posterior surface of the broad ligament, confirmed in 83/138 cases (60.1%). As for the other sites, the histologic confirmation rates in the ovarian surface, bowel serosa, and vesicouterine fold of the peritoneum were 48%, 40%, and 13%, respectively. CONCLUSION: Endometriosis has a multiple appearance, and the lesions may be confused with nonendometriotic lesions. It is clear that a nonhistology-based diagnosis may lead to unnecessary prolonged medical treatment and operations and may delay the proper treatment measures from being applied. Therefore, a meticulous histological confirmation should still be the first step in the laparoscopic diagnosis and treatment of suspected endometriosis.

Endometriosis↗

PubMed2003

[Association between glutathione S-transferase M1 gene deletion and genetic susceptibility to endometriosis].

OBJECTIVE: To evaluate the possible association of the glutathione S-transferase M1 (GSTM1) gene polymorphism with the susceptibility to endometriosis in women of Han nationality in Guangdong Province. METHODS: Polymerase chain reaction was used to identify the GSTM1 genotypes in 76 patients with endometriosis and 80 controls (surgical patients for gynecological problems other than endometriosis). RESULTS: The frequencies of the GSTM1 null genotypes in patients with endometriosis and controls were 65.8% and 46.3%, respectively, showing a significant difference between the endometriotic cohort and the control group (X(2)=6.03, P < 0.05). Individuals with GSTM1 null genotype were exposed to risks for endometriosis 2.24 times that of subjects without these genotypes OR=2.24, 95% CI=1.17-4.27 . CONCLUSION: GSTM1 gene deletion might bea risk factor for endometriosis in women of Han nationality who are native residents in Guangdong Province.

Adult↗

PubMed2003

Abdominal wall endometriosis. An overlooked diagnosis.

OBJECTIVE: To study the incidence of abdominal wall endometriosis after cesarean section and its presentation to the general surgeon. METHODS: Fourteen patients were treated for abdominal wall endometriosis during the period June 1997 to May 2002 at Princess Basma Teaching Hospital and King Abdulla University Hospital, Irbid, Jordan. The patient's files were reviewed to see their way and time of presentation after cesarean section, provisional diagnosis made and operative procedures performed. Symptoms suggestive of and investigations carried out to detect pelvic endometriosis were also looked for and recorded. RESULTS: Fourteen patients were treated within 5 years; all had painful scar-related mass. The pain was exacerbating during menstruation in 5. The clinical diagnosis was stitch granuloma in 3; incisional hernia in 3, abdominal wall tumor in 3 and abdominal wall endometrioma in 5 patients. The mean time for the mass to be noticed by the patient was 2 years. They were treated with wide local excision. Histopathological examination proved the diagnosis of abdominal wall endometriosis. None had evidence of pelvic endometriosis and none of them had recurrence. The incidence of the disease is around 0.2% of the cesarean sections performed during the same period. CONCLUSION: The treating physician should keep in mind abdominal wall endometriosis as a possible cause of post cesarean section scar-related masses.

Abdominal Wall↗

PubMed2003

Endometriosis in adolescents--analysis of 6 cases.

OBJECTIVE: To study the characteristics, diagnosis and treatment of endometriosis in adolescent patients. METHOD: Six cases of adolescent endometriosis in our hospital were reviewed retrospectively. RESULT: Endometriosis is the most common cause of chronic pelvic pain in adolescents. There may be a natural progression of endometriosis from atypical lesions in adolescents to classic lesions in adults. Congenital abnormalities of the reproductive tract are the main reasons for the adolescent endometriosis. CONCLUSION: Endometriosis should be strongly suspected in adolescent girls with chronic pelvic pain, especially unresponsive to oral contraceptives and nonsteroidal anti-inflammatory drugs. The treatment involves the operations and medicines.

Adolescent↗

PubMed1992

Evaluation of endometrial tissue specific complement activation in women with endometriosis.

OBJECTIVE: To determine if endometrial tissue specific complement (C) activation occurs in patients with endometriosis. DESIGN: Prospective. SETTING: University of Oklahoma Health Sciences Center, a tertiary care referral center. PATIENTS: Twenty-six women, 9 with endometriosis and 17 without endometriosis. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Uterine and ectopic endometria were evaluated by the immunofluorescence assay for the presence of activated products of the initial (C3d) and terminal (C5b-9) C pathway, C3 regulatory proteins (decay-accelerating factor and membrane cofactor protein), and terminal C regulatory proteins (clusterin and vitronectin). RESULTS: The initial (C3d) and terminal (C5b-9) C components were deposited on blood vessel walls in uterine and/or ectopic endometria of women with and without endometriosis. In the stromal compartment at both sites, C deposition was colocalized with terminal C inhibitors/cell-cell attachment factors, clusterin and vitronectin on elastic fibers. No specific staining for C proteins was detected on the glandular epithelium of uterine and ectopic endometrial tissues examined. Furthermore, intense staining of endometrial epithelium for C3 regulatory proteins, decay-accelerating factor, and membrane cofactor protein was noted on endometrial glands from women with and without endometriosis. CONCLUSIONS: Our findings demonstrate a lack of specific deposition of C in the glandular epithelial cells of endometria of women with endometriosis. The localization of C3 regulatory proteins, decay-accelerating factor, and membrane cofactor protein on glandular epithelium may suggest the involvement of intrinsic protective mechanisms on these cells from autologous C attack in vivo.

Adult↗

PubMed2003

Peritoneal fluid environment in endometriosis. Clinicopathological implications.

Endometriosis is a puzzling disorder with obscure pathogenesis. The objective of this review was to evaluate the complex role of peritoneal fluid in the etiopathogenesis of endometriosis. Several studies suggest that peritoneal fluid is a key inflammatory environment associated with endometriosis. Many active substances (cytokines, growth factors, hormones and oxidative stress parameters) have been identified in endometriosis patients at different stages of the disease. Inflammatory mediators may be involved in the endometriosis associated-infertility and possibly pain. Furthermore, these mediators may represent a non surgical method for diagnosing endometriosis. Better understanding of the mechanism of cytokines, growth factor and reactive oxygen species production and detoxification and further investigation of their effects on the peritoneal fluid environment are essential to obtain new insight into this disease and eventually develop novel diagnostic and therapeutic remedies.

Ascitic Fluid↗

PubMed2003

[Innate immunity participation in the pathogenesis of endometriosis].

UNLABELLED: Endometriosis is a serious clinical problem among the women treated because of gynecological reasons. The frequency of its occurrence is estimated for 10-15% of all women at reproductive age. AIM: This study evaluates the chosen phenomenons participating in innate immunity and their role in the pathogenesis of endometriosis. MATERIALS AND METHODS: 42 patients aged 22 to 39 years old treated in Surgical Gynecology Department of Polish Mother Health Centre Research Institute were the study group. Comparative group consisted of 22 age-matched women with no clinical complains. We evaluated production of reactive oxygen intermediates by peripheral blood neutrophils in both groups of women (both spontaneous and stimulated with fMLP) using the chemiluminescence test. We used neutrophils, both resting and previously preactivated with TNF-alpha. The activity of C3 and C4 complement components and total antioxidant status were also measured. RESULTS: Showed that the chemiluminescence values were higher in patients with endometriosis than in comparative group. Preactivation of neutrophils with the use of TNF-alpha was significantly weakened. Both C3 and C4 complement components revealed higher activity in women with endometriosis as compared to those without this disease. Total antioxidant status values were significantly lower in patients with endometriosis than in women from the comparative group. CONCLUSION: Innate immunity may play a significant role in the pathogenesis of endometriosis due to changes in its components activity that are observed in the course of this disease.

Adult↗

PubMed2004

[Expression of vascular endothelial growth factor and endostatin in peritoneal fluid of patients with endometriosis].

OBJECTIVE: To investigate the relationship of vascular endothelial growth factor (VEGF) and endostatin with endometriosis. METHODS: The levels of vascular endothelial growth factor and endostatin were measured using ELISA in 50 women with endometriosis (stage I-II26 cases and stage III-IV 24 cases) in comparison with 42 women without endometriosis. RESULTS: The VEGF, endostatin concentrations and VEGF/endostatin ratio in endometriosis group were significantly higher than the mean value in the control group (P<0.01). The VEGF and endostatin levels in stages III and IV were both significantly higher than those in stages I and II(397+/-81 pg/ml vs 315+/-64 pg/ml, 125+/-62 ng/ml vs 66+/-40 ng/ml, P<0.01). However, the VEGF/endostatin ratio was lower in the advanced stages. There was no significant difference between follicular phase and luteal phase except that the VEGF level in follicular phase was higher than that in luteal phases. CONCLUSIONS: Both VEGF and endostatin may play a role in the regulation of angiogenesis of endometriosis, and the balance of angiogenic stimulators and inhibitors may be critical to the development of endometriosis.

Adolescent↗

PubMed1992

[Gestrinone in the therapy of sterility due to endometriosis].

Thirty-two infertile women with laparoscopic diagnosis of asymptomatic pelvic endometriosis were treated with gestrinone 2.5 mg twice weekly for 6 months. Subsequently, a second-look laparoscopy was performed in all of them. All of the patients were followed for at least 12 months after the end of treatment, during which time they attempted to conceive. Ten (31.25%) from all 32 treated women became pregnant. The highest incidence of pregnancy was in the stage I (12.5%) and II (12.5%) (rAFS) of endometriosis, a half of them in stage III (6.25%) and no pregnancy was recorded in the stage IV found prior to the beginning of therapy. There was no statistically significant (chi 2-test) relationship between the reduction of laparoscopic findings (defined as a visual extermination or as a decrease in staging of endometriosis) and pregnancy. In 19 (59.4%) from 32 treated women the stage of endometriosis remained unchanged, in 9 (28.3%) it was reduced by one up to three stages and in 4 (12.5%) the endometriosis was visually eliminated. In no case the staging of endometriosis was worsened during therapy. Gestrinone was well tolerated. In no one of patients it was necessary to interrupt the treatment untimely.

Adult↗

PubMed2003

[Physiopathology, diagnosis and therapeutic management of stage III and IV endometriosis].

Stage III endometriosis is defined by a r-AFS score respectively ranging from 16 to 40 and stage IV over 40. Deep pelvic endometriosis presents essentially in the form of a painful syndrome dominated by chronic pelvic painful, dysmenorrhea and deep dyspareunia. Pathophysiology of pelvic pain associated with endometriosis remains unknown. In the literature, correlation between extension of the endometriosis and severity of the painful remains controversies. Contraception by levonorgestrel-releasing intra-uterine systems appears to decrease pain related to deeply infiltrating endometriosis. Surgery by laparoscopy remains the first intention treatment when infertility is associated with endometriosis, whereas medical treatment is only palliative in the majority of cases. Success of treatment depends on how radical surgical exeresis is. Spontaneous pregnancy rates are significantly increased after surgical treatment. Recurrent ovarian surgery is not recommended in women with infertility, as it might be deleterious for ovarian reserve. Medical treatment using Gn-RH agonists is indicated when recurrence occurs after surgery.

Endometriosis↗

PubMed2003

[Biological aspects of endometriosis in vitro fertilization].

Rinsing cumulus oophorus after oocyte retrieval is routinely performed in our department in Lyon for in vitro fertilization procedures when ovarian endometriosis is suspected. The aim of this procedure is to remove factors which might alter oocyte and embryo quality and fertilization and pregnancy rates. These factors, such as Tumor Necrosis Factor alpha (TNFalpha) and reactive oxygen species are known to be surexpressed in endometriosis. Their effect is not exclusively on the development of the oocyte and embryo but also on fertilization and implantation. It has been demonstrated that peritoneal and follicular fluid contains some factors that interfere with effective gamete interaction, as it has been determined by an in vitro animal assay. Peritoneal fluid from patients with mild endometriosis has an increased activity of TNFalpha, interleukin-1 (IL-1), antibodies and reactive oxygen species. This observation might be of importance in explaining subfertility associated with early stages of endometriosis. Cumulus-oophorus rinsing after oocyte retrieval might help to remove these deleterious factors. IVF outcomes in women affecting by endometriosis seem to be similar after cumulus-oophorus rinsing, as compared to those of patients undergoing IVF for tubal-factor infertility. This rinsing procedure could also be usefull in women affected by unexplained infertility: peritoneal and follicular fluid of these women contains increased levels of TNFalpha and reactive oxygen species, like women affected by endometriosis.

Endometriosis↗