In order to evaluate the expression of HLA-DR antigen in glandular cells in eutopic and ectopic endometrium in patients with endometriosis, 19 infertile patients with endometriosis were analyzed immunohistochemically by labelled streptavidin biotin (LSAB) method. Nineteen infertile patients without endometriosis were studied as controls. The results showed that the expression of HLA-DR antigen in the glandular cells in both eutopic and ectopic endometrium was increased significantly as compared with that in the controls (P < 0.01). It is likely that aberrant expression of HLA-DR antigen in endometriotic tissue is involved in abnormal immunogenesis of endometriosis.
Endometriosis/complications ; Endometriosis/*immunology ; Endometrium/*immunology ; HLA-DR Antigens/*immunology ; Immunohistochemistry ; Infertility/complications ; Infertility/*immunology ; Pelvis

Abdominal Injuries ; complications ; Adenosarcoma ; etiology ; Adult ; Cicatrix ; complications ; Endometriosis ; complications ; Female ; Humans

Adult ; Endometriosis ; diagnosis ; pathology ; Female ; Humans ; Leiomyomatosis ; complications ; diagnosis ; pathology ; Peritoneal Neoplasms ; complications ; diagnosis ; pathology

Adult ; Endometriosis ; complications ; Female ; Humans ; Ileal Diseases ; etiology ; Intestinal Diseases ; complications ; Intestinal Perforation ; etiology

OBJECTIVE: To explore the differences in the factors associated with endometriosis between Chinese and British patients. METHODS: This case-control study was conducted in 387 patients with endometriosis and 199 non-endometriosis patients admitted to John Radcliffe Hospital (Oxford, UK) and in 101 patients with endometriosis and 50 non-endometriosis patients admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The clinical data including height, weight, body mass index, marital status, employment, menstruation, fertility, and operation reasons were collected via a standardized WERF EPHect questionnaire. RESULTS: Multivariate logistic regression analysis indicated that body mass index, surgery for dysmenorrhea, history of pregnancy, counts of previous surgeries for endometriosis and status of employment were all significantly associated with endometriosis in the UK (P < 0.05), while a history of dysmenorrhea was significantly correlated with endometriosis in Chinese patients (P < 0.05). CONCLUSION Dysmenorrhea may be the most important common factor associated with endometriosis in China and the UK, but the other factors contributing to endometriosis may differ between these two countries.
Case-Control Studies ; Dysmenorrhea/complications* ; Endometriosis/complications* ; Female ; Humans ; Menstruation ; Pregnancy ; United Kingdom

Objective: To investigate the familial heritability of endometriosis and to compare the clinical characteristics of patients with or without a family history of endometriosis. Methods: From January 2020 to June 2022, 850 patients with endometriosis confirmed by laparotomy or laparoscopy in Peking University Third Hospital were included in this study. Clinical data were collected, family history was followed up, and the differences of clinical indicators between patients with and without family history of endometriosis were compared. Results: A total of 850 patients were enrolled, with an average age of (33.8±7.0) years old, 315 (37.1%, 315/850) patients in stage Ⅲ and 496 (58.4%, 496/850) patients in stage Ⅳ. There were 100 patients with family history of endometriosis, accounting for 11.8% (100/850). Most of the 113 relatives involved were mothers, daughters and sisters (76.1%, 86/113), 81.5% (22/27) of the second and third degree relatives were maternal relatives. The median ages of patients with and without family history of endometriosis were 30 and 33 years old respectively at the time of diagnosis. The unmarried rate of patients with family history was higher [42.0% (42/100) vs 26.3% (197/750)]. The percentage of dysmenorrhea patients with family history was higher [89.0% (89/100) vs 55.5% (416/750)]. The medians of dysmenorrhea score in patients with and without family history were 6 and 2, and the median durations of dysmenorrhea were 10 and 1 years. There were significant differences in age, marital status, percentage of dysmenorrhea, dysmenorrhea score and duration (all P<0.001). The median levels of serum cancer antigen (CA) 125 in patients with family history and patients without family history at the time of diagnosis were 57.5 and 46.9 kU/L respectively, with a statistically significant difference (P<0.05). However, there were no significant differences between the two groups in nationality, bady mass index, menarche age, menstrual cycle, menstrual period, menstrual volume, serum CA_19-9 level, cyst location and size, stage, history of adverse pregnancy and childbirth, infertility, adenomyosis and deep infiltrating endometriosis (all P>0.05). By comparing the specific conditions of dysmenorrhea patients with and without family history of endometriosis, there were no significant differences between the two groups in terms of the age of onset of dysmenorrhea, duration of dysmenorrhea, primary and secondary dysmenorrhea, and progressive aggravation of dysmenorrhea (all P>0.05). The difference in the degree of dysmenorrhea in dysmenorrhea patients with family history of endometriosis was significant (P<0.001). Conclusions: The incidence of endometriosis has a familial tendency, and most of the involved relatives are the first degree relatives. Compared with patients without family history of endometriosis, endometriosis patients with family history are diagnosed at an earlier age, with higher percentage of dysmenorrhea, had more severe dysmenorrhea and higher serum CA₁₂₅ level.
Pregnancy ; Female ; Humans ; Adult ; Endometriosis/complications* ; Dysmenorrhea/etiology* ; Menstruation ; Menstrual Cycle ; Adenomyosis/complications*

Epithelial-mesenchymal transition plays an important role in the development and progression of endometriosis. Mesenchymal-epithelial transition is involved in forming localized lesions of endometriosis, while EMT is involved in the injury, repair and fibrosis induced by local inflammation of endometriosis and the process of cell invasion and metastasis. The studies of signal transduction pathway and related proteins of epithelial-mesenchymal transition in the process of endometriosis may provide new targets for diagnosis and treatment of endometriosis.
Endometriosis ; complications ; etiology ; pathology ; physiopathology ; Epithelial-Mesenchymal Transition ; physiology ; Female ; Fibrosis ; complications ; Humans ; Inflammation ; complications ; Signal Transduction ; physiology

Most of malignant tumors arising in ovarian and extraovarian endometriosis are carcinomas. Mixed mullerian tumor and endometrial stromal sarcoma arising in intestinal endometriosis are rarely described, but its clinicopathologic features have not been well characterized. Here we report a case of endometrial stromal sarcoma of the sigmoid colon arising in endometriosis with a review of six additional cases of endometrial stromal sarcoma arising in intestinal endometriosis found in English literatures. The patients ranged in age from 36 to 64 yr. Presenting symptoms were pain, bloody diarrhea, and tenesmus. Some patients had a previous history of endometriosis. Most of the tumors arose in the rectosigmoid colon. The histologic features were the same as their uterine counterpart. No death of disease had been reported. This rare tumor should not be confused with gastrointestinal stromal tumor clinically and histologically.
Endometriosis/*complications ; Female ; Humans ; Middle Aged ; Sarcoma, Endometrial Stromal/*pathology ; Sigmoid Neoplasms/*pathology

Pancreatic endometrial cyst is an extremely rare instance of ectopic endometriosis that was first described by Marchevsky in 1984(1)). A 21-yr-old woman with a history of epigastric pain and weight loss was found to have a cystic lesion in the pancreas on CT-scan. Under the tentative diagnosis of a pancreatic cystic neoplasm, partial pancreatectomy was performed. Histopathological examination of the specimen revealed cystic endometriosis. The clinicopathological features of the lesion are discussed and literature concerning this extremely rare lesion is reviewed.
Adult ; Choristoma/*pathology/surgery ; Endometriosis/*complications/pathology ; Female ; Human ; Pancreatectomy ; Pancreatic Cyst/*etiology/pathology/surgery

Congenital absence of the uterine cervix and vagina in the presence of a functional endometrium is an extremely rare congenital anomaly. Women born with this anomaly present with collection of blood in the uterine cavity or hematometra, disabling pelvic pain and progressively worsening endometriosis. Presented is a case of a 16 year-old girl with severe pelvic endometriosis and hematometra complicated by cervicovaginal agenesis. She was managed by total abdominal hysterectomy with bilateral salpingectomy, left oophorocystectomyandadhesiolysis. Surgical management of congenital cervicovaginal agenesis remains controversial. The decision to do a conservative surgical procedure or a hysterectomy depends on the clinical profile of the patient, the expertise of the surgeon, the extent of the malformation and its association with other mullerian anomalies.