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Current perspectives on diagnosis and management of primary and secondary breast endometriosis and potential risk of breast cancer 认领 引用
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作者 Alexandra G Marneri Efstathios T Pavlidis +4 位作者 Kalliopi E Stavrati Christina Mouratidou Athanasios Kofinas Irida Konstantopoulou Theodoros E Pavlidis 《World Journal of Clinical Oncology》 2026年第4期74-84,共11页
Breast endometriosis represents an exceptionally rare extragenital manifestation of ectopic endometrial tissue,with only a few histologically confirmed breast cases reported worldwide.There appears to be a potential r... Breast endometriosis represents an exceptionally rare extragenital manifestation of ectopic endometrial tissue,with only a few histologically confirmed breast cases reported worldwide.There appears to be a potential relationship between endometriosis and an increased risk of developing breast cancer.The proposed mechanisms include chronic inflammation,oxidative stress,hormonal dysregulation,and genetic factors such as mutations in the GATA binding protein 2,phosphatase and tensin homolog,Kirsten rat sarcoma viral oncogene homolog,and AT-rich interactive domaincontaining protein 1A genes,as well as alterations in circulating microRNAs,primarily miR-199a and the let-7 family of miRNAs.However,the molecular mechanisms underlying this association are not yet fully understood.A structured literature search revealed a small number of primary and secondary breast cases,all of which were confirmed by histopathology.Primary lesions occurred spontaneously,whereas secondary cases were associated with prior breast surgery,suggesting possible implantation of endometrial tissue during surgical manipulation.Morphologic diagnosis relies on identifying endometrial glands and stroma,supported by immunoreactivity for CD10 and paired box gene 8 and negativity for GATA binding protein 2.Clinically,lesions may present as palpable nodules or painful masses,often mimicking malignancy or fat necrosis,particularly in patients with a history of reconstructive or reduction surgery.Complete surgical excision was curative in all reported cases,with no recurrence or malignant transformation documented during follow-up.Although exceedingly rare,recognition of this entity is essential to avoid misdiagnosis and to enhance the understanding of the mechanisms underlying ectopic endometrial implantation in extrapelvic sites such as the breast. 展开更多
关键词 Endometriosis Mammary endometriosis Rare breast lesions Genomic profile of endometriosis Ectopic extrapelvic location Palpable nodules Painful masses Malignant transformation risk
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Honghua Ruyi Pill,a compound herbal medicine,improves endometriosis-related dysmenorrhea:A multicenter randomized,double-blind,placebo-controlled trial 认领 引用
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作者 Mei Han Xue-fang Liang +7 位作者 Jing Gao Yan Wang Li-xing Cao Bao-jin Wang Yue Wang Zerang Zhuoma Jian-ping Liu Hui-lan Du 《Journal of Integrative Medicine》 SCIE CAS CSCD 2026年第2期182-191,共10页
Background:Endometriosis is an estrogen-dependent,progesterone-resistant gynecological disorder,with dysmenorrhea being the most common manifestation.Objective:This study evaluates the efficacy and safety of the Tibet... Background:Endometriosis is an estrogen-dependent,progesterone-resistant gynecological disorder,with dysmenorrhea being the most common manifestation.Objective:This study evaluates the efficacy and safety of the Tibetan herbal medication Honghua Ruyi Pill(HHRY)in managing endometriosis-related dysmenorrhea.Design,setting,participants and interventions:This is a multi-center,randomized,placebo-controlled,double-blinded clinical trial conducted in seven hospitals in China from July 2021 to January 2023.A total of 164 patients with endometriosis and moderate or severe dysmenorrhea(visual analog scale[VAS]score≥4)were assigned to the treatment or placebo group in a 1:1 ratio by block randomization.Patients received HHRY or placebo twice a day for three consecutive menstrual cycles(MCs)and were followed up for three MCs after stopping the medication.Main outcome measures:Primary outcomes were VAS score of the maximum(VASmax)of dysmenorrhea,endometriosis health profile-5(EHP-5)score,and 5-level EuroQoL 5-dimension version(EQ-5D-5L)score.Secondary outcomes were VASmaxof non-menstrual pelvic pain,days of leave taken,emergent use of nonsteroidal anti-inflammatory drugs(NSAIDs)and changes in uterine,cyst and nodule sizes.Safety profiles were assessed based on adverse events,vital signs,serology markers,urinalysis,and liver and kidney function indicators.Results:VASmaxof dysmenorrhea,EHP-5 score,EQ-5D-5 L score,and VASmaxof non-menstrual pelvic pain were significantly lower in the HHRY group compared to the placebo group at the final follow-up(3.00 vs 5.50,P0.999),but the number of patients who had taken time off was significantly different(5.00 vs 14.00,P=0.028).Sonographic evaluations indicated no significant change in uterine size(P=0.183)but showed a significant reduction in cyst size(2.09 cm vs 0.20 cm,P=0.027,sum of 3 diameters of cysts)and nodule size(0.70 cm vs 0.00 cm,P<0.001,maximum nodule diameter).Safety analysis showed no significant difference in the incidence of adverse events between groups(18.85%vs 28.05%,P=0.059).Conclusion:HHRY can improve dysmenorrhea,chronic pelvic pain,and quality of life in patients with endometriosis.It has a good overall safety profile,and a 3-month treatment can maintain its effects for at least 3 months after the last dose.HHRY may be considered as a new therapeutic option for treating endometriosis-related dysmenorrhea. 展开更多
关键词 Honghua Ruyi Pill Herbal medicine Endometriosis Dysmenorrhea Quality of life Non-menstrual pelvic pain
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Microbiota–metabolite axis in endometriosis:Pathogenic mechanisms and clinical implications 认领 引用 被引量：1
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作者 Moyuan Li Aiyuan Yue +6 位作者 Lingfeng Gu Feiyang Li Nuo Ye Sujuan Xu Zhen Gong Dake Li Pengfei Xu 《Journal of Biomedical Research》 CAS CSCD 2026年第4期347-363,共17页
Growing evidence highlights the gut,reproductive tract,and endometrial microbiota as important functional contributors in the pathogenesis of endometriosis(EM).Studies have revealed a characteristic microbial imbalanc... Growing evidence highlights the gut,reproductive tract,and endometrial microbiota as important functional contributors in the pathogenesis of endometriosis(EM).Studies have revealed a characteristic microbial imbalance in patients with EM,marked by a reduced abundance of beneficial bacteria and an enrichment of opportunistic pathogens.These microbial communities are thought to influence disease progression primarily through metabolic activity,as demonstrated by metabolomic studies showing their capacity to modulate host immune and endocrine responses.This imbalance may contribute to several key metabolic disturbances,including decreased levels of short-chain fatty acids,particularly butyrate;a shift in tryptophan metabolism toward the kynurenine pathway;elevated β-glucuronidase activity;increased lipopolysaccharide production;and altered secondary bile acid profiles.Functionally,these metabolic alterations are thought to contribute to EM by disrupting immune homeostasis,enhancing estrogen signaling,and driving systemic inflammation,thereby creating a permissive microenvironment for ectopic lesion growth and invasion.Targeted interventions,such as probiotics,high-fiber dietary strategies,fecal microbiota transplantation,and selective modulation of microbial or host metabolic enzymes,are emerging as promising non-hormonal therapeutic approaches.Nonetheless,further studies incorporating longitudinal cohort designs and integrative multi-omics approaches are essential to establish causality and facilitate the development of precise diagnostic and personalized treatment strategies. 展开更多
关键词 endometriosis microbiota metabolite
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The association between HPV infection and endometriosis:Risk and fertility outcomes 认领 引用 被引量：1
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作者 Wenqu Li Zhenlong Wang +5 位作者 Huizhi Qi Chengjie Xia Feixue Chen Juan Xu Lei Zhang Xuemei Jia 《Journal of Biomedical Research》 CAS CSCD 2026年第4期383-394,I0004-I0005,共12页
While infections have been implicated in endometriosis pathogenesis,the role of human papillomavirus(HPV)remains unclear.This study combined a meta-analysis of seven studies with a case-control study(n=432surgically t... While infections have been implicated in endometriosis pathogenesis,the role of human papillomavirus(HPV)remains unclear.This study combined a meta-analysis of seven studies with a case-control study(n=432surgically treated patients)to evaluate the association of HPV infection with endometriosis risk and fertility outcomes.The meta-analysis showed no significant association between HPV infection and endometriosis risk,either for any HPV subtype(pooled odds ratio[OR]=2.60,95%confidence interval[CI]:0.28–23.87)or highrisk subtypes(OR=1.68,95%CI:0.49–5.75).Notably,HPV prevalence was higher in patients with endometriosis(46%overall;36%for high-risk subtypes)than in the general population.Evidence regarding the association between HPV infection and fertility outcomes remains limited,with only two eligible studies identified.Our case-control analysis revealed that HPV-positive patients had significantly reduced postoperative live birth rates compared with HPV-negative counterparts(10.6%vs.21.0%,P<0.05).These findings suggest that HPV infection is unlikely to be a major risk factor for endometriosis development,but it may be associated with poorer postsurgical fertility outcomes.The dual-method approach strengthens the evidence for HPV's clinical impact on reproductive prognosis in patients with existing endometriosis. 展开更多
关键词 human papillomavirus endometriosis female infertility pregnancy outcomes meta-analysis casecontrol analysis
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Comparison of pregnancy outcomes and vaginal microbiota in women with endometriosis undergoing frozen embryo transfer using letrozole combined with HMG versus hormone replacement therapy with GnRH-a pretreatment 认领 引用 被引量：1
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作者 Jie Zhang Lei Dai +4 位作者 Chunyan Jiang Yuxin Zhao Xiang Ma Yugui Cui Jiayin Liu 《Journal of Biomedical Research》 CAS CSCD 2026年第4期395-409,I0006-I0010,共15页
This study investigated differences in reproductive outcomes and vaginal microbiota profiles between two endometrial preparation protocols—letrozole(LE)combined with human menopausal gonadotropin(HMG)and hormone repl... This study investigated differences in reproductive outcomes and vaginal microbiota profiles between two endometrial preparation protocols—letrozole(LE)combined with human menopausal gonadotropin(HMG)and hormone replacement therapy(HRT)with gonadotropin-releasing hormone agonist(GnRH-a)pretreatment—in women with endometriosis undergoing frozen embryo transfer(FET).Following 1∶1 propensity score matching,a total of 770 FET cycles were analyzed.No statistically significant differences were observed in live birth rates or clinical pregnancy rates between the two groups.However,the LE+HMG group showed a nonsignificant trend toward a lower miscarriage rate(13.7%vs.19.8%,P=0.070),as well as lower observed rates of cesarean delivery(64.9%vs.75.4%,P=0.020)and hypertensive disorders of pregnancy(4.8%vs.10.1%,P=0.039).Previous evidence suggests an association between GnRH-a treatment and reproductive tract microbiota composition.Given the clinical and ethical constraints of endometrial sampling during FET,vaginal microbiota was evaluated as a non-invasive indicator of lower reproductive tract microbial composition.In the prospective arm,vaginal samples from 55 women in the LE+HMG group and 50 in the GnRH-a HRT group were analyzed using 16S rRNA sequencing and droplet digital PCR.While no significant differences were observed in Lactobacillus or Gardnerella abundance,the GnRH-a HRT group showed higher relative abundances of several low-abundance taxa,such as Escherichia-Shigella,Limosilactobacillus,and Staphylococcus.In conclusion,although both protocols achieved comparable live birth outcomes,the LE+HMG regimen was associated with lower rates of cesarean delivery and hypertensive disorders of pregnancy,while the two protocols exhibited differences in several low-abundance vaginal bacterial taxa.However,longitudinal studies incorporating baseline and repeated sampling are needed to clarify temporal relationships and causality. 展开更多
关键词 endometriosis letrozole gonadotropin-releasing hormone agonist frozen embryo transfer vaginal microbiota
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A novel mouse model of endometriosis:Simulating the recurrent hemorrhagic microenvironment of clinical lesions 认领 引用
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作者 Yu Zhuang Yan Zan +5 位作者 Tiantian Ma Xiaoquan Huang Junwei Li Liangjun Xia Yuping Sa Youbing Xia 《Animal Models and Experimental Medicine》 CAS CSCD 2026年第5期1037-1046,共10页
Current models of endometriosis(EMs)still have limitations in replicating the key pathological features of human EMs,particularly the cyclic bleeding associated with ectopic lesions.To address this gap,this study aime... Current models of endometriosis(EMs)still have limitations in replicating the key pathological features of human EMs,particularly the cyclic bleeding associated with ectopic lesions.To address this gap,this study aimed to develop a proof-of-concept mouse model that incorporates repeated retrograde hemorrhagic exposure through the intraperitoneal injection of endometrial fragments,followed by repeated intraperitoneal injections of fresh whole blood.An EMs model was established in female C57BL/6J mice via intraperitoneal injection of endometrial fragments combined with saline or whole blood,respectively.The model was systematically evaluated using ectopic lesion burden,peritoneal adhesion scores,histopathological staining,immunohistochemistry,enzyme-linked immunosorbent assay(ELISA),and quantitative reverse transcription polymerase chain reaction(RT-qPCR).Both models successfully recapitulated the fundamental pathological features of EMs.However,the intraperitoneal injection of whole blood(IPBI)protocol induced a markedly greater lesion burden,together with more pronounced histopathological and molecular alterations,and recapitulated repeated exposure to retrograde menstruation.In addition,the IPBI group exhibited more robust systemic biomarker responses,indicating enhanced clinical relevance.The present study successfully established a proof-of-concept EMs mouse model that introduces repeated retrograde hemorrhagic exposure to create a clinically relevant,blood-stimulated microenvironment.This model provides a reliable tool for investigating the pathogenesis of EMs and developing therapeutic strategies. 展开更多
关键词 ectopic lesion endometriosis mouse model recurrent hemorrhage
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Enhanced detection of vascularization in rectal endometriosis:A comparative study of microvascular flow and power Doppler 认领 引用
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作者 Juan Luis Alcazar Diego Maria Pich Barroso +3 位作者 Oscar Sanchez Ignacio Brunel Jose Carlos Vilches Rodrigo Orozco 《World Journal of Radiology》 2026年第5期60-66,共7页
BACKGROUND Conventionally,rectal endometriotic nodules have been considered as poorly vascularized.However,new,more sensitive,Doppler techniques have been developed recently for assessing microvascularization.These ne... BACKGROUND Conventionally,rectal endometriotic nodules have been considered as poorly vascularized.However,new,more sensitive,Doppler techniques have been developed recently for assessing microvascularization.These new techniques might allow microvascularity in these lesions.AIM To compare the vascularization of rectal endometriotic nodules using microvascular(MV)flow and conventional power Doppler.METHODS Thirty consecutive women diagnosed with deep endometriosis involving the rectum were recruited for this prospective study.All women underwent transvaginal ultrasound using a Samsung V8 ultrasound system(Samsung Medison,Co.,Ltd.,Seoul,South Korea).The scanning protocol was performed according to the International Deep Endometriosis Analysis consensus.Endometriotic lesions involving the rectum were identified as hypoechoic lesions with blurred margins.Then,power Doppler was activated and the vascularization of the lesion was assessed.Immediately after,the MV-Flow™ with the LumiFlow™ was activated and the vascularization was assessed again.Vascularization assessment was undertaken based on the subjective examiner’s impression,using the vascular score proposed by International Ovarian Tumor Analysis group.RESULTS The vascular score using conventional power Doppler was score 1 in 87%(n=26)and score 2 in 13%(n=4)of the lesions,respectively.The vascular score using MV-Flow™was score 1 in 6%(n=2),score 2 in 27%(n=8),score 3 in 40%(n=12)and score 4 in 27%(n=8)of the cases.Grouping cases into score 1-2 vs score 3-4,there was a statistically significant difference with score 3-4 when using MV-Flow™(67%vs 0%,P<0.01).CONCLUSION This study shows that many rectal endometriotic nodules exhibit more vascularization than previously thought when using MV-Flow™. 展开更多
关键词 Endometriosis Vascularization Doppler Ultrasound Microvascular flow
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Characterization of endometriosis in patients with Mullerian anomalies using the Enzian classification: A retrospective cohort study 认领 引用
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作者 Ishan Kumar Shweta Kumari +4 位作者 Ritu Ojha Rupam Kumari Kajal Kushwaha Pramod Kumar Singh Ashish Verma 《World Journal of Radiology》 2026年第3期8-17,共10页
BACKGROUND Mullerian anomalies are frequently associated with endometriosis,particularly in the presence of genital tract obstruction;however,the anatomical distribution and determinants of disease in this population ... BACKGROUND Mullerian anomalies are frequently associated with endometriosis,particularly in the presence of genital tract obstruction;however,the anatomical distribution and determinants of disease in this population remain incompletely characterized.Most existing data are derived from surgical series,with limited use of standardized imaging-based classification systems.AIM To characterize the prevalence and distribution of endometriosis in patients with Mullerian anomalies using pelvic magnetic resonance imaging(MRI)and the Enzian classification.METHODS This retrospective observational study included pelvic MRI examinations performed over a 15-month period.Patients whose MRI reports described Mullerian anomalies were identified,and imaging datasets were re-evaluated.Mullerian anomalies were classified using the Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy system.Endometriosis was assessed on MRI and mapped using the Enzian classification,including ovarian(O),peritoneal(P),and deep infiltrating tissue(T)involvement across pelvic compartments.The presence of genital tract obstruction was determined based on MRI evidence of hemorrhagic collections.RESULTS Seventy-five patients with Mullerian anomalies were included.MRI findings consistent with endometriosis were identified in 22 patients(29.3%).Ovarian endometriomas were the most common manifestation,present in 16 patients(21.3%),while tubo-ovarian involvement corresponding to Enzian T2-T3 disease was seen in 11 patients(14.7%).Endometriosis was more frequently observed in complex uterine configurations,particularly bicorporeal septate uterus(U3c),aplastic uterus with a functional rudimentary cavity(U5a),and in patients classified as U0 with associated cervicovaginal anomalies.Vaginal aplasia(V4)was associated with a significantly lower prevalence of endometriosis compared with normal vaginal anatomy(P=0.019).Genital tract obstruction showed a strong association with endometriosis,with affected patients demonstrating nearly threefold higher prevalence compared with non-obstructive anomalies(61.5%vs 22.6%,P=0.005).CONCLUSION Endometriosis in patients with Mullerian anomalies demonstrates variable distribution on MRI,with higher prevalence in complex and obstructive uterine configurations.MRI combined with standardized Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy and Enzian classifications provides a structured,anatomy-driven approach for evaluating disease patterns in this heterogeneous population. 展开更多
关键词 Mullerian duct anomalies Endometriosis Magnetic resonance imaging Enzian classification Genital tract obstruction
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Impact of Endometrial Polyps on Pregnancy Outcomes in Patients with Endometriosis and Infertility: A Systematic Review and Meta-analysis 认领 引用 被引量：3
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作者 Liang Zhang Qian Han +1 位作者 Meiru Bao Ying Wu 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2025年第3期341-350,共10页
Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data dat... Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women. 展开更多
关键词 Endometriosis Endometrial polyps Infertility Pregnancy outcome Meta-analysis
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Depression and anxiety in patients with endometriosis-associated chronic pain:Neuroimmune mechanisms mediated by inflammatory factors 认领 引用 被引量：1
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作者 Fan-Chun Yang Yang Zhou +1 位作者 Shi-Yun Zhang Rui Ma 《World Journal of Psychiatry》 SCIE 2025年第10期109-119,共11页
BACKGROUND Endometriosis affects approximately 10%of reproductive-age women and is frequently associated with chronic pelvic pain.Patients with endometriosis often experience comorbid depression and anxiety,but the un... BACKGROUND Endometriosis affects approximately 10%of reproductive-age women and is frequently associated with chronic pelvic pain.Patients with endometriosis often experience comorbid depression and anxiety,but the underlying mechanisms connecting these conditions are unclear.AIM To assess the prevalence of depression and anxiety in endometriosis patients and explore neuroimmune mechanisms mediated via inflammatory biomarkers.METHODS A retrospective cohort study was conducted with 200 patients with endometriosis-associated chronic pain from June 2020 to December 2024.Depression and anxiety were assessed using validated psychological instruments.Inflammation biomarkers interleukin(ILs)(IL-6,IL-1β),tumor necrosis factor-alpha,C-reactive protein,and brain-derived neurotrophic factor were measured in serum.Pain severity was assessed using visual analog scales.Correlation and regression analyses were performed to examine relationships between inflammatory markers,pain severity,and psychological outcomes.RESULTS Among the 200 patients,42.5%exhibited clinically significant depression and 51.0%showed anxiety symptoms.Serum levels of IL-6,IL-1β,tumor necrosis factor-alpha,and C-reactive protein were significantly higher in patients with comorbid depression and anxiety compared with those without psychological symptoms(P<0.001).Brainderived neurotrophic factor levels were lower in the depression group.Pain severity positively correlated with inflammatory marker levels and with depression and anxiety scores.CONCLUSION Overall,the findings suggest that inflammatory factors mediate a neuroimmune mechanism linking endometriosisassociated chronic pain with depression and anxiety.Therapeutic targets for managing psychological comorbidities in patients with endometriosis through anti-inflammatory interventions should be explored,and an integrated treatment approach addressing both physical and psychological symptoms is emphasized. 展开更多
关键词 Endometriosis Chronic pain Depression Anxiety Inflammation Neuroimmune Cytokines Brain-derived neurotrophic factor
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PMEPA1-Mediated Treg Cell Impairment Promotes Endometrial Stromal Invasion via Excessive PI3K/AKT Signaling in Endometriosis 认领 引用
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作者 Ya-qin Peng Lu Wang +4 位作者 Ai-li Tan Shu-jun Wang Wen Zou Xing Li Jing Yang 《Current Medical Science》 SCIE CAS CSCD 2025年第5期1231-1243,共13页
Objective Although immune dysregulation is implicated in the pathogenesis of endometriosis(EMs),the specific role of prostate transmembrane protein androgen induced 1(PMEPA1)in modulating the function of regulatory T ... Objective Although immune dysregulation is implicated in the pathogenesis of endometriosis(EMs),the specific role of prostate transmembrane protein androgen induced 1(PMEPA1)in modulating the function of regulatory T cells(Tregs)remains inadequately understood.This study aimed to elucidate the regulatory mechanisms by which PMEPA1 influences the activity of Tregs,thereby facilitating the invasion of endometrial stromal cells(ESCs).Methods Single-cell RNA sequencing(scRNA-seq)was performed on matched ectopic ovarian lesions and eutopic endometria from 3 patients.Clinical specimens from patients with EMs and control subjects were examined for PMEPA1 expression.Primary human Tregs isolated from peripheral blood mononuclear cells were subjected to PMEPA1 overexpression(via plasmid)or knockdown(via siRNA).Modulation of the PI3K pathway was conducted via the activator 740Y-P or the inhibitor LY294002.The secretion of IL-10 and TGF-βby Tregs was quantified using an enzyme-linked immunosorbent assay.Ectopic ESCs cocultured with modified Tregs were assessed for their proliferation,migration,and invasion capabilities.Results scRNA-seq data revealed significant upregulation of PMEPA1 in Tregs from ectopic ovarian lesions compared with paired eutopic endometria.PMEPA1 expression was increased in the ectopic lesions and peritoneal fluid mononuclear cells of patients with EMs.Tregs overexpressing PMEPA1 demonstrated reduced secretion of IL-10 and TGF-βbut exhibited hyperactivation of the PI3K/AKT signaling pathway.Treatment with LY294002 ameliorated the impairment in cytokine secretion.Coculture experiments with Tregs expressing high levels of PMEPA1 resulted in increased invasion,migration,and proliferation of ESCs.Conclusion PMEPA1 impairs Treg-mediated immunosuppression by hyperactivating the PI3K/AKT pathway,thereby facilitating the invasiveness of ESCs in EMs. 展开更多
关键词 Prostate transmembrane protein androgen induced 1 Regulatory T cells PI3K/AKT signaling Endometriosis Stromal cells
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Prediction of genomic biomarkers for endometriosis using the transcriptomic dataset 认领 引用
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作者 Zeynep Kucukakcali Sami Akbulut Cemil Colak 《World Journal of Clinical Cases》 2025年第20期6-19,共14页
BACKGROUND Endometriosis is a clinical condition characterized by the presence of endometrial glands outside the uterine cavity.While its incidence remains mostly uncertain,endometriosis impacts around 180 million wom... BACKGROUND Endometriosis is a clinical condition characterized by the presence of endometrial glands outside the uterine cavity.While its incidence remains mostly uncertain,endometriosis impacts around 180 million women worldwide.Despite the presentation of several epidemiological and clinical explanations,the precise mechanism underlying the disease remains ambiguous.In recent years,researchers have examined the hereditary dimension of the disease.Genetic research has aimed to discover the gene or genes responsible for the disease through association or linkage studies involving candidate genes or DNA mapping techniques.AIM To identify genetic biomarkers linked to endometriosis by the application of machine learning(ML)approaches.METHODS This case-control study accounted for the open-access transcriptomic data set of endometriosis and the control group.We included data from 22 controls and 16 endometriosis patients for this purpose.We used AdaBoost,XGBoost,Stochasting Gradient Boosting,Bagged Classification and Regression Trees(CART)for classification using five-fold cross validation.We evaluated the performance of the models using the performance measures of accuracy,balanced accuracy,sensitivity,specificity,positive predictive value,negative predictive value and F1 score.RESULTS Bagged CART gave the best classification metrics.The metrics obtained from this model are 85.7%,85.7%,100%,75%,75%,100%and 85.7%for accuracy,balanced accuracy,sensitivity,specificity,positive predictive value,negative predictive value and F1 score,respectively.Based on the variable importance of modeling,we can use the genes CUX2,CLMP,CEP131,EHD4,CDH24,ILRUN,LINC01709,HOTAIR,SLC30A2 and NKG7 and other transcripts with inaccessible gene names as potential biomarkers for endometriosis.CONCLUSION This study determined possible genomic biomarkers for endometriosis using transcriptomic data from patients with/without endometriosis.The applied ML model successfully classified endometriosis and created a highly accurate diagnostic prediction model.Future genomic studies could explain the underlying pathology of endometriosis,and a non-invasive diagnostic method could replace the invasive ones. 展开更多
关键词 Endometriosis RNA-seq Transcriptomics Machine learning Classification
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Deep endometriosis with pericolic lymph node involvement: A case report and literature review 认领 引用 被引量：4
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作者 Andrea Cacciato Insilla Monnalisa Granai +5 位作者 Grazia Gallippi Patrizia Giusti Sabina Giusti Simone Guadagni Luca Morelli Daniela Campani 《World Journal of Gastroenterology》 SCIE CAS 2014年第21期6675-6679,共5页
Deep infiltrating endometriosis is an often-painful disorder affecting women during their reproductive years that usually involves the structures of the pelvis and frequently the gastrointestinal tract.We present the ... Deep infiltrating endometriosis is an often-painful disorder affecting women during their reproductive years that usually involves the structures of the pelvis and frequently the gastrointestinal tract.We present the case of a 37-year-old female patient with an endometrial growth on the sigmoid colon wall causing pain,diarrhea and the presence of blood in the feces.The histology of the removed specimen also revealed the involvement of the utero-vesical fold,the recto-vaginal septum and a pericolic lymph node,which are all quite uncommon findings.To identify the endometrial cells,we performed immunohistochemical staining for CD10and the estrogen and progesterone receptors. 展开更多
关键词 Deep infiltrating endometriosis Gastrointestinal tract Recto-sigmoid endometriosis Recto-vaginal node Lymph node endometriosis Lymph node removal
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Adenomyosis-associated uterine rupture and pulmonary endometriosis mimicking advanced-stage uterine malignancy in an adolescent female:A case report 认领 引用
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作者 U Chul Ju Woo Dae Kang Seok Mo Kim 《World Journal of Clinical Cases》 2025年第28期84-90,共7页
BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which... BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which may mimic malignancy.Here,we describe a case of adenomyosis-associated uterine rupture(secondary to hemorrhagic necrosis)and concurrent pulmonary endometriosis in a 16-year-old girl initially suspected of having advanced uterine cancer.CASE SUMMARY A 16-year-old girl presented with acute abdominal pain and oliguria.Imaging studies revealed a 15-cm ruptured uterine mass accompanied by hemoperitoneum and multiple pulmonary nodules suggestive of metastatic disease.Laboratory tests demonstrated severe anemia and markedly elevated tumor markers[cancer antigen(CA)-125:1063 U/mL;CA-19-9:1347 U/mL].Emergency laparotomy revealed adenomyosis-associated uterine rupture secondary to hemorrhagic necrosis,with no macroscopic abnormalities in other organs.A total abdominal hysterectomy was performed.Histopathological analysis confirmed uterine adenomyosis with hemorrhagic necrosis.Subsequent thoracoscopic wedge resections of the pulmonary lesions demonstrated histologically confirmed endometriosis.The patient has remained disease-free under treatment with oral dienogest.CONCLUSION This case of an adolescent patient highlights how benign gynecological conditions can mimic malignancy,necessitating broad differential diagnoses despite alarming presentations. 展开更多
关键词 Adolescent Uterine adenomyosis Pulmonary endometriosis Hemorrhagic necrosis Gynecological malignancy Case report
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Bowel endometriosis: Colorectal surgeon's perspective in a multidisciplinary surgical team 认领 引用 被引量：3
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作者 Albert M Wolthuis Christel Meuleman +3 位作者 Carla Tomassetti Thomas D'Hooghe Anthony de Buck van Overstraeten André D'Hoore 《World Journal of Gastroenterology》 SCIE CAS 2014年第42期15616-15623,共8页
Endometriosis is a gynecological condition that presents as endometrial-like tissue outside the uterus and induces a chronic inflammatory reaction. Up to 15% of women in their reproductive period are affected by this ... Endometriosis is a gynecological condition that presents as endometrial-like tissue outside the uterus and induces a chronic inflammatory reaction. Up to 15% of women in their reproductive period are affected by this condition. Deep endometriosis is defined as endometriosis located more than 5 mm beneath the peritoneal surface. This type of endometriosis is mostly found on the uterosacral ligaments, inside the rectovaginal septum or vagina, in the rectosigmoid area, ovarian fossa, pelvic peritoneum, ureters, and bladder, causing a distortion of the pelvic anatomy. The frequency of bowel endometriosis is unknown, but in cases of bowel infiltration, about 90% are localized on the sigmoid colon or the rectum. Colorectal involvement results in alterations of bowel habits such as constipation, diarrhea, tenesmus, dyschezia, and, rarely, rectal bleeding.Differential diagnosis must be made in case of irritable bowel syndrome,solitary rectal ulcer syndrome,and a rectal tumor.A precise diagnosis about the presence,location,and extent of endometriosis is necessary to plan surgical treatment.Multidisciplinary laparoscopic treatment has become the standard of care.Depending on the size of the lesion and site of involvement,fullthickness disc excision or bowel resection needs to be performed by an experienced colorectal surgeon.Longterm outcomes,following bowel resection for severe endometriosis,regarding pain and recurrence rate are good with a pregnancy rate of 50%. 展开更多
关键词 Endometriosis Colorectal endometriosis Deeply infiltrative endometriosis Laparoscopy Diagno-sis Treatment
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Bowel endometriosis:Recent insights and unsolved problems 认领 引用 被引量：6
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作者 Simone Ferrero Giovanni Camerini +3 位作者 Umberto Leone Roberti Maggiore Pier L Venturini Ennio Biscaldi Valentino Remorgida 《World Journal of Gastrointestinal Surgery》 2011年第3期31-38,共8页
Bowel endometriosis affects between 3.8% and 37% of women with endometriosis.The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis.Transvaginal ultras... Bowel endometriosis affects between 3.8% and 37% of women with endometriosis.The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis.Transvaginal ultrasonography is the first line investigation in patients with suspected bowel endometriosis and allows accurate determination of the presence of the disease.Radiological techniques (such as magnetic resonance imaging and multidetector computerized tomography enteroclysis) are useful for estimating the extent of bowel endometriosis.Hormonal therapies (progestins,gonadotropin releasing hormone analogues and aromatase inhibitors) significantly improve pain and intestinal symptoms in patients with bowel stenosis less than 60% and who do not wish to conceive.However,hormonal therapies may not prevent the progression of bowel endometriosis and,therefore,patients receiving long-term treatment should be periodically monitored.Surgical excision of bowel endometriosis should be offered to symptomatic patients with bowel stenosis greater than 60%.Intestinal endometriotic nodules may be excised by nodulectomy or segmental resection.Both surgical procedures improve pain,intestinal symptoms and fertility.Nodulectomy may be associated with a lower rate of complications. 展开更多
关键词 Bowel endometriosis Diagnosis Endometriosis Gonadotropin releasing hormone analogue Laparoscopy Nodulectomy Progestin Colorectal resection
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Immune pathway through endometriosis to ovarian cancer 认领 引用 被引量：2
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作者 Mariana Santos Calmon Fabian Fellipe Bueno Lemos +5 位作者 Marcel Silva Luz Samuel Luca Rocha Pinheiro Luis Guilherme de Oliveira Silva Gabriel Lima Correa Santos Gabriel Reis Rocha Fabrício Freire de Melo 《World Journal of Clinical Oncology》 2024年第4期496-522,共27页
Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting aroun... Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic disorder.Although endometriosis is a benign disease,it shares several characteristics with invasive cancer.Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic processes.This is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and endometrioid.However,the carcinogenic pathways between both pathologies remain poorly understood.Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and hyperestrogenism.This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their ramifications.Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments. 展开更多
关键词 Ovarian neoplasms Endometriosis Endometriosis-associated ovarian cancers Immune response Immunotherapy
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Inguinal endometriosis: Ten case reports and review of literature 认领 引用 被引量：1
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作者 Shu-Hong Li Heng-Zi Sun +1 位作者 Wei-Hua Li Shu-Zhen Wang 《World Journal of Clinical Cases》 SCIE 2021年第36期11406-11418,共13页
BACKGROUND To describe the characteristics,diagnosis and surgical treatment of inguinal endometriosis(IEM).CASE SUMMARY We retrospectively analyzed 10 patients diagnosed with IEM at Beijing Chao-Yang Hospital from 201... BACKGROUND To describe the characteristics,diagnosis and surgical treatment of inguinal endometriosis(IEM).CASE SUMMARY We retrospectively analyzed 10 patients diagnosed with IEM at Beijing Chao-Yang Hospital from 2011 to 2019.Relevant features,symptoms,images,surgical treatment,hormonal therapy and follow-up were collected and discussed.A total of 10 cases of IEM diagnosed by surgery and pathology were characterized by a lesion on the right side(9/11);five patients had symptoms related to the menstrual cycle,and only 3 patients were clearly diagnosed before surgery.Ultrasonography was of little assistance in confirming the diagnosis,but magnetic resonance imaging showed specific,high-intensity patterns.Anatomically,most of the IEM lesions were located in the extraperitoneal ligament(10/11);nine patients had inguinal hernias(IH),five had concurrent or prior pelvic endometriosis,and four had infertility.The clinical results from extensive resection were satisfactory.CONCLUSION IEM is an extremely rare condition that can easily be misdiagnosed prior to surgery.A right IH may contribute to the formation of right-sided IEM,and extensive resection involving the round ligament and hernia sac is essential to prevent recurrence. 展开更多
关键词 Inguinal endometriosis Clinical characteristics Imaging examination Pelvic endometriosis Treatment Case report
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Intestinal endometriosis:Diagnostic ambiguities and surgical outcomes 认领 引用 被引量：4
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作者 Jun Woo Bong Chang Sik Yu +5 位作者 Jong Lyul Lee Chan Wook Kim Yong Sik Yoon In Ja Park Seok-Byung Lim Jin Cheon Kim 《World Journal of Clinical Cases》 SCIE 2019年第4期441-451,共11页
BACKGROUND Endometriosis is a common disease for women of reproductive age. However,when it involves intestines, it is difficult to diagnose preoperatively because its symptoms overlap with other diseases and the resu... BACKGROUND Endometriosis is a common disease for women of reproductive age. However,when it involves intestines, it is difficult to diagnose preoperatively because its symptoms overlap with other diseases and the results of evaluations can be unspecific. Thus it is important to know the clinical characteristics of intestinal endometriosis and how to exactly diagnose.AIM To analyze patients in whom intestinal endometriosis was diagnosed after surgical treatments, and to evaluate the clinical characteristics of preoperatively misdiagnosed cases.METHODS We retrospectively reviewed the pathologic reports of 30 patients diagnosed as having intestinal endometriosis based on surgical specimens between January2000 and December 2017. We reviewed their clinical characteristics and surgical outcomes.RESULTS Twenty-three(76.6%) patients showed symptoms associated with endometriosis,with dysmenorrhea being the most common(n = 9, 30.0%). Thirteen patients(43.3%) had a history of pelvic surgeries. Ten patients(33.3%) had a history of treatment for endometriosis. Only 4 patients(13.3%) had a diagnosis of endometriosis based on endoscopic biopsy findings. According to preoperative evaluations, 13 patients(43.3%) had an initial diagnosis of pelvic endometriosis and 17 patients(56.6%) were misdiagnosed as having other diseases. The most common misdiagnosis was submucosal tumor in the large intestine(n = 8, 26.7%),followed by malignancies of the colonectum(n = 3, 10.0%) and ovary(n = 3,10.0%). According to the Clavien-Dindo classification, 5 complications were grade I or II and 2 complications were grade IIIa. The median follow-up period was 26.9(0.6-132.1) mo, and only 1 patient had a recurrence of endometriosis.CONCLUSION Intestinal endometriosis is difficult to diagnose preoperatively because it mimics various intestinal diseases. Thus, if women of reproductive age have ambiguous symptoms and signs with nonspecific radiologic and/or endoscopic findings,intestinal endometriosis should be included in the differential diagnosis. 展开更多
关键词 Endometriosis Intestinal endometriosis Diagnosis Surgery Treatment
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Laparoscopic umbilical trocar port site endometriosis:A case report 认领 引用 被引量：3
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作者 Xue Ao Wei Xiong Shi-Qiao Tan 《World Journal of Clinical Cases》 SCIE 2020年第8期1532-1537,共6页
BACKGROUND Abdominal wall endometriosis can occur secondary to gynecological and obstetric pelvic laparotomy;however,this is a rare clinical event.There are few cases of endometriosis involving the incision site of a ... BACKGROUND Abdominal wall endometriosis can occur secondary to gynecological and obstetric pelvic laparotomy;however,this is a rare clinical event.There are few cases of endometriosis involving the incision site of a laparoscopic surgery,especially for those of the endometrial nodule at the umbilical trocar port site where the camera is placed.CASE SUMMARY We describe the case of a 37-year-old woman who presented with a 2-year history of a tough swelling below the umbilicus,which presented periodical pain during menstruation.The patient had undergone laparoscopic ovarian cystectomy 4 years prior,and we theorized that the umbilical nodule was a complication of that laparoscopic surgery.Histological analysis confirmed the diagnosis of abdominal umbilical scar endometriosis secondary to previous laparoscopic surgery.Surgical removal of the nodule followed by three cycles of leuprorelin was curative.CONCLUSION Abdominal mass and pain in women of childbearing age with a previous history of pelvic surgery should support consideration of endometriosis at the surgical site. 展开更多
关键词 Endometriosis Laparoscopy Abdominal wall Scar endometriosis Ovarian cystectomy Case report
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