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Comparing endometriotic lesions with eutopic endometrium: time to shift focus?
Human Reproduction ( IF 6.1 ) Pub Date : 2021-09-08 , DOI: 10.1093/humrep/deab208
Eliza M Colgrave 1 , Janet R Keast 2 , Sophie Bittinger 3 , Martin Healey 1 , Peter A W Rogers 1 , Sarah J Holdsworth-Carson 1 , Jane E Girling 1, 4
Affiliation  

Endometriosis is a heterogeneous disease in terms of patient symptoms, treatment responsiveness and the presentation of endometriotic lesions. This article explores the histological features of endometriotic lesions, highlighting their sometimes underappreciated heterogeneity. We note the variability in evidence for and against the menstrual cycle responsiveness of lesions and consider the utility of drawing parallels between endometriotic lesions and eutopic endometrium. We ask whether histopathologic features beyond just the presence/absence of endometrial-like glands and/or stroma could help improve disease stratification. At the same time, we acknowledge the desire of many clinicians and patients to avoid invasive surgery thereby limiting the ability to histologically phenotype lesions. The ability to derive clinically useful histological information from endometriotic lesions, in association with patient data, would be invaluable to clinicians to help improve treatment options in such a diverse group of patients. However, in suggesting that a shift in focus may enable the development of a better patient stratification system, we recognise that our wish for a single comprehensive stratification system may be beyond reach for a disease of such diverse presentation.

中文翻译:

比较子宫内膜异位病变与在位子宫内膜:是时候转移焦点了?

就患者症状、治疗反应性和子宫内膜异位病变的表现而言,子宫内膜异位症是一种异质性疾病。本文探讨了子宫内膜异位病变的组织学特征,强调了它们有时被低估的异质性。我们注意到支持和反对病变对月经周期反应性的证据的可变性,并考虑在子宫内膜异位病变和在位子宫内膜之间绘制平行线的效用。我们询问除了子宫内膜样腺体和/或基质的存在/不存在之外的组织病理学特征是否有助于改善疾病分层。同时,我们承认许多临床医生和患者希望避免侵入性手术,从而限制了组织学表型病变的能力。从子宫内膜异位病变中获取临床有用的组织学信息并结合患者数据的能力对于临床医生帮助改善此类不同患者群体的治疗选择非常宝贵。然而,在提出关注焦点的转变可能有助于开发更好的患者分层系统时,我们认识到,对于具有如此多样化表现的疾病,我们希望建立一个单一的综合分层系统可能是遥不可及的。
更新日期:2021-09-08
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