Objective: To investigate the relationship between magnetic resonance imaging (MRI) imaging characteristics and clinical symptoms and therapeutic efficacy in adenomyosis patients. Methods: The clinical characteristics of the adenomyosis questionnaire was self-designed. This was a retrospective study. From September 2015 to September 2020, totally 459 patients were diagnosed with adenomyosis and underwent pelvic MRI examination at Peking University Third Hospital. Clinical characteristics and treatment were collected, MRI was used to determine the lesion location, and to measure the maximum lesion thickness, the maximum myometrium thickness, uterine cavity length, uterine volume, the minimum distance between the lesion and serosa or endometrium, and whether combined with ovarian endometrioma. The difference of MRI imaging characteristics in patients with adenomyosis and its relationship with clinical symptoms and therapeutic efficacy were analyzed. Results: (1) Among the 459 patients, the age was (39.1±6.4) years. There were 376 patients (81.9%, 376/459) with dysmenorrhea. Whether patients had dysmenorrhea were related to uterine cavity length, uterine volume, ratio of the maximum lesion thickness to the maximum myometrium thickness, and whether patients had ovarian endometrioma (all P<0.001). Multivariate analysis suggested that ovarian endometrioma was the risk factor for dysmenorrhea (OR=0.438, 95%CI: 0.226-0.850, P=0.015). There were 195 patients (42.5%, 195/459) with menorrhagia. Whether patients had menorrhagia were related to age, whether patients had ovarian endometrioma, uterine cavity length, the minimum distance between lesion and endometrium or serosa, uterine volume, ratio of the maximum lesion thickness to the maximum myometrium thickness (all P<0.001). Multivariate analysis suggested that ratio of the maximum lesion thickness to the maximum myometrium thickness was the risk factor for menorrhagia (OR=774.791, 95%CI: 3.500-1.715×10⁵, P=0.016). There were 145 patients (31.6%, 145/459) with infertility. Whether the patients had infertility were related to age, the minimum distance between lesion and endometrium or serosa, and whether patients had ovarian endometrioma (all P<0.01). Multivariate analysis suggested that young and large uterine volume were risk factors for infertility (OR=0.845, 95%CI: 0.809-0.882, P<0.001; OR=1.001, 95%CI: 1.000-1.002, P=0.009). (2) The success rate of in vitro fertilization-embryo transfer (IVF-ET) was 39.2% (20/51). Dysmenorrhea, high maximum visual analogue scale score and large uterine volume affected the success rate of IVF-ET (all P<0.05). The smaller the maximum lesion thickness, the smaller the distance between the lesion and serosa, the larger the distance between the lesion and endometrium, the smaller the uterine volume, and the smaller the ratio of the maximum lesion thickness to the maximum myometrium thickness, the better the therapeutic efficacy of progesterones (all P<0.05). Conclusions: Concomitant ovarian endometrioma increases the risk of dysmenorrhea in patients with adenomyosis. The ratio of the maximum lesion thickness to the maximum myometrium thickness is an independent risk factor for menorrhagia. Young and large uterine volume may increase the risk of infertility. Severe dysmenorrhea and large uterine volume affect the success rate of IVF-ET. The therapeutic efficacy of progesterones is relatively better when the lesion is small and far away from the endometrium.
Female ; Humans ; Adult ; Middle Aged ; Adenomyosis/pathology* ; Dysmenorrhea/therapy* ; Menorrhagia/pathology* ; Endometriosis/therapy* ; Retrospective Studies ; Infertility/complications* ; Magnetic Resonance Imaging

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

No abstract available.
Abdomen/pathology/surgery ; Adult ; Endometrial Neoplasms/complications/*pathology/radiography/surgery ; Endometriosis/complications/*pathology/radiography/surgery ; Female ; Humans ; Image Enhancement/*methods ; Imaging, Three-Dimensional/*methods ; Pelvis/pathology/radiography/surgery ; Radiography, Abdominal ; Sarcoma, Endometrial Stromal/complications/*pathology/radiography/surgery ; *Software ; Specimen Handling

No abstract available.
Adult ; Colon/diagnostic imaging ; Colonoscopy ; Coronary Stenosis/*diagnosis/etiology ; Endometriosis/complications/*diagnosis/pathology ; Female ; Humans ; Middle Aged ; Neprilysin/metabolism ; Tomography, X-Ray Computed ; Ultrasonography

Endometriosis (EMs) is a common gynecologic disease that affects women's physical and mental health seriously. The pathogenesis is still unknown and the mechanism of endometriosis-associated pain remains unclear. Mast cells (MC) are known to be multifunctional players in the immune system. Recent studies have shown that nerve fibers in EMs lesions can release neural peptides such as nerve growth factor and substance P to induce MC degranulating and releasing histamine, proteases, cytokines, chemokines etc., which contributes to the development of pain and hyperalgesia in patients with endometriosis.
Endometriosis ; complications ; metabolism ; pathology ; Female ; Humans ; Mast Cells ; metabolism ; Nerve Growth Factor ; metabolism ; Pelvic Pain ; etiology ; pathology

OBJECTIVETo investigate the clinical features and factors involved in the drug resistance and prognosis of ovarian clear cell adenocarcinoma (OCCA).

METHODSForty-seven OCCA patients and 53 ovarian serous cyst adenocarcinoma (OSCA) patients were included in this study. Their clinical characteristics, drug resistance, and prognostic factors were analyzed.

RESULTSThe onset age of OCCA was (49.09 + 11.80) years old, and that of OSCA was (55.51 + 1.38) year old. There were 53.3% (24/45) of OCCA and 98.0% (50/51) of OSCA patients who had elevated CA125 levels. There were 46.8% (22/47) of OCCA patients and 7.5% (4/53) of OSCA patients who suffered from endometriosis (EMS). The percentage of early stage (stage I and stage II) OCCA was 80.9% (38/47), and that of OSCA was 11.3% (6/53). A statistically significant difference was observed on all these aspects (P < 0.05). The percentage of drug resistant OCCA was 26.1% (12/46), and that of OSCA was 24.0% (12/50), with a non-significant difference (P = 0.814).Among the patients with advanced stage disease, the percentage of drug resistance was 87.5% (7/8) for OCCA, while that of OSCA was 25.0% (11/44), showing a statistically significant difference (P = 0.003). Multiple logistic regression analysis revealed that OCCA (OR = 21.774, 95%CI: 2.438 to 194.431) and advanced stage (OR = 58.329, 95%CI: 5.750 to 591.703) were independent risk factors of drug resistance in ovarian epithelial cancers. For the advanced stage patients, the median overall survival time of OCCA and OSCA were 11 and 29 months, respectively, with a statistically significant difference (P = 0.000). Cox survival analysis showed that OCCA, advanced stage, suboptimal surgery, fewer than 6 cycles of chemotherapy and drug resistance were all risk factors of OS in ovarian cancer patients (P < 0.05).

CONCLUSIONSThe age of onset in OCCA patients is younger than that of OSCA patients. The proportion of combination with endometriosis (EMS) is higher, and more early stage disease is observed in OCCA patients. The percentage of drug resistant in OCCA is higher, especially in advanced stage patients. The prognosis of advanced stage OCCA patients is poorer than that of OSCA patients in advanced stage.

Adenocarcinoma, Clear Cell ; complications ; drug therapy ; metabolism ; pathology ; surgery ; Adult ; CA-125 Antigen ; metabolism ; Cystadenocarcinoma, Serous ; complications ; drug therapy ; metabolism ; pathology ; surgery ; Drug Resistance, Neoplasm ; Endometriosis ; complications ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Staging ; Ovarian Diseases ; complications ; Ovarian Neoplasms ; complications ; drug therapy ; metabolism ; pathology ; surgery ; Proportional Hazards Models ; Survival Rate

No abstract available.
Colectomy/methods ; Colonic Neoplasms/*diagnosis ; Colonoscopy ; Endometriosis/complications/*diagnosis/pathology/surgery/ultrasonography ; *Endosonography ; Female ; Humans ; Laparoscopy ; Middle Aged ; Muscle Neoplasms/*diagnosis ; Pelvic Pain/etiology ; Predictive Value of Tests ; Sigmoid Diseases/complications/*diagnosis/pathology/surgery/ultrasonography

The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data were consistent with DIC, and it was believed to be related to myometrial injury resulting from heavy intramyometrial menstrual flow. Gonadotropin is considered to play an important role in the development of fulminant DIC. This rare case suggests that physicians should be aware that gonadotropin may provoke fulminant DIC in women with adenomyosis.
Acute Kidney Injury/*diagnosis/etiology ; Adult ; Creatinine/blood ; Disseminated Intravascular Coagulation/*chemically induced/complications ; Endometriosis/*complications/diagnosis/surgery ; Female ; Fertilization in Vitro ; Gonadotropins/*adverse effects ; Humans ; Magnetic Resonance Imaging ; Menstruation/*physiology ; Uterus/pathology/surgery

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

Adnexa Uteri ; surgery ; Colectomy ; methods ; Colonic Diseases ; etiology ; pathology ; surgery ; Colostomy ; Endometriosis ; complications ; pathology ; surgery ; Female ; Fistula ; etiology ; pathology ; surgery ; Follow-Up Studies ; Humans ; Intestinal Fistula ; etiology ; pathology ; surgery ; Middle Aged ; Ovarian Cysts ; complications ; pathology ; surgery ; Ovarian Diseases ; etiology ; pathology ; surgery ; Ovariectomy