内异症患者在位内膜病理特征分析

Study on pathological characteristics of eutopic endometrium in endometriosis

目的 分析内异症患者在位内膜病理特征.方法 回顾性分析2007年1月至2008年12月在北京协和医院经手术治疗、病理证实为盆腔内异症的176例患者的在位内膜病理特征.结果 72.2％（127/176）患者的在位内膜处于增殖期.35例（19.9％,35/176）为子宫内膜息肉,其中32例为单纯子宫内膜息肉,3例为子宫内膜异常增生合并子宫内膜息肉;子宫内膜异常增生者7例（4.0％,7/176）;在位内膜病变发生率为22.2％（39/176）.53例合并不孕症者在位内膜病变发生率为35.9％（19/53）,高于无不孕症者的16.3％（20/123）,两者比较,差异有统计学意义 （x2=8.24,P=0.004）.65例合并月经异常者,子宫内膜息肉和子宫内膜异常增生的发生率分别为20.0％（13/65）、10.8％（7 /65）,均分别高于月经正常者17.1％（19/111）和0,两者比较,差异有统计学意义（x2=13.839,P=0.003）.结论 内异症患者在位内膜细胞处于持续增殖状态,内异症合并不孕症患者以及月经异常者在位内膜病变的发生率显著增高.

Objective To study the pathologic characteristics of eutopic endometrium in patients with endometriosis.Methods Pathologic characteristics of eutopic endometrium were studied in 176 patients with endometriosis in Peking Union Medical College Hospital from January 2007 to December 2008 retrospectively.Results About 72.2%（127/176）of eutopic endometrium were in proliferative phase,19.9%（35/176）of were observed as endometrial polyp,including 32 cases with simple endometrial polyp and 3 cases with abnormal hyperplasia combined with endometrial polyp.And 4.0%（7/176）showed abnormal hyperplasia.The incidence of pathologic changes in eutopic endometrium was 22.2%（39/176）.Among 53 endometriosis patients combined with infertility,the incidence of pathologic changes of eutopic endometrium was 35.9%（19/53）,which was significantly higher than 16.3% in non-infertile patients （x2 =8.24,P =0.004）.Among 65 cases with irregular menstruation,the incidence of endometrial polypus and endometrial hyperplasia were 20.0%（13/65）and 10.8%（7/65）,which were significantly higher than 17.1%（19/111）and 0 in normal menstruation patients（x2 =13.839,P =0.003）.Conclusions The eutopic endometrium of endometriosis were in proliferative phase state.The pathologic changes of eutopic endometrium were more in patients combined with infertility and irregular menstruation.