Global Transcriptome Abnormalities of the Eutopic Endometrium From Women With Adenomyosis
Christopher N. HerndonLusine AghajanovaShaina BalayanDavid W. EriksonFatima BarraganGabriel GoldfienKim Chi VoShannon M. HawkinsLinda C. Giudice
88
Citation
61
Reference
10
Related Paper
Citation Trend
Keywords:
Adenomyosis
Myometrium
Adenomyosis is a relatively frequent finding in series of hysterectomies performed for menorrhagia and dysmenorrhea. Evident selection biases of the available studies on adenomyosis have always limited the possibilities of defining the real clinical importance of the condition. Until now the only certain diagnoses have been made by histopathologists on uteri removed at surgery, but recently various sufficiently accurate techniques have been suggested which allow diagnosis on the uterus in situ. With the these methods it might be possible to obtain correct information on the epidemiologic characteristics of adenomyosis and to clarify whether it has a pathogenic role in unexplained ovulatory menorrhagia and juvenile dysmenorrhea. Furthermore, resectoscopic treatment has been proposed in some mild forms of adenomyosis to avoid hysterectomy, whereas it seems improbable that medical treatment can offer a definitive solution. The adoption of standard histologic criteria for adenomyosis seems important. Until this is done, it will be difficult to establish whether adenomyosis is really a disease or merely a paraphysiologic condition.
Adenomyosis
Cite
Citations (56)
Adenomyosis was classically defined by Bird, et al. as 'Benign invasion of endometrium in the myometrium producing a diffusely enlarged uterus which microscopically exhibits ectopic nonneoplastic endometrial glands and stroma surrounded by hypertrophic and hyperplastic myometrium'. It is this hypertrophic and hyperplastic myometrium that needs to be tailored in the surgical management of adenomyosis and hence holds a lot of importance in the entire discussion of adenomyosis.
Adenomyosis
Myometrium
Cite
Citations (0)
Myometrium
Cite
Citations (27)
Purpose: Recently, focal adenomyosis was classified into three subtypes according to magnetic resonance imaging findings: connected to the endometrium (subtype I), connected to the perimetrium (subtype II), and not connected to either the endometrium or the perimetrium (subtype III). However, diffuse adenomyosis and cystic adenomyosis have not been investigated. We attempted to classify diffuse-type adenomyosis and cystic-type adenomyosis according to magnetic resonance imaging findings and verified the validity of the previous classification of focal adenomyosis. Methods: A total of 1504 cases of adenomyosis (focal, n = 1093; nodular, n = 15; diffuse, n = 383; cystic, n = 13) shown in magnetic resonance imaging findings of patients who underwent conservative surgical treatment from 2002 to 2016 at our hospital were reviewed according to the criteria of Kishi. Results: Of the 383 patients with diffuse adenomyosis, 272 (70.8%) were classified as subtype I, while all cases of cystic-type adenomyosis developed in the lateral wall of the uterus were classified as subtype III. Conclusion: Our findings indicate that diffuse adenomyosis develops from the same mechanism as focal adenomyosis subtype I. In addition, we consider that subtype III has greater relationship with cystic adenomyosis than the other types.
Adenomyosis
Cite
Citations (1)
[Objective] To determine the expression of angiopoietin-2 (Ang-2) in eutopic and ectopic endometrium of endometriosis and adenomyosis, and to investigate the role of it in the pathogenesis of endometriosis and adenomyosis. [Methods] Expression of Ang-2 mRNA in the eutopic and ectopic endometrium of 65 patients with endometriosis (endometriosis group) and 40 patients with adenomyosis (adenomyosis group) and the expression of Ang-2 mRNA in the normal endometrium of 30 patients (control group) without endometriosis and adenomyosis were detected by RT-PCR. [Results] Expression levels of Ang-2 mRNA in the eutopic and ectopic endometrium with endometriosis and adenomyosis were significantly higher than that in control group, and there was not significant relevance between the expression level and the clinical staging. [Conclusion] Expression of Ang-2 mRNA has a high level in the eutopic and ectopic endometriotic tissues with endometriosis and adenomyosis. Ang-2 may play a very important role in the development of endometriosis and adenomyosis and may relate to the pathogenesis of endometriosis and adenomyosis.
Adenomyosis
Pathogenesis
Clinical Significance
Cite
Citations (0)
Objective:To investigate the expression of MMP-2 and VEGF in different parts of adenomyosis and the roles of these factors in the pathophysiology of uterine adenomyosis.Methods:56 patients with histologically proved adenomyosis and 26 patients with normal uterus were adopted to detect expression of MMP-2 and VEGF in endometrium and myometrium of uterus by immunohistochemical staining.Results:The positive expression rate of MMP-2 in ectopic and eutopic endometrium were 71.4% and 67.5%, respectively, were higher than that of normal endometrium (42.3%, P﹤0.05). The positive expression rates of MMP-2 in myometrium around the ectopic lesions was significantly higher than that of normal myometrium (67.9% vs 34.6%, P﹤0.01); The positive expression rate of VEGF in eutopic and normal endometrium were 52.5% and 46.2%, respectively, were significantly lower than that of ectopic endometrium (75%,P0.05). The positive expression rates of VEGF in myometrium around ectopic lesions was significantly higher than that of normal myometrium (69.6% vs 38.5%, P0.05); The expression of MMP-2 was significantly correlated with VEGF in adenomyosis (P﹤0.01).Conclusion:The overexpression of MMP-2 in endometrium and myometrium may be related to overgrowth of smooth muscle of uterus and invasiveness of endometrium tissue during progression of adenomyosis. The overexpression of VEGF have close relationship with adenomyosis angiogenesis. MMP-2 and VEGF are two important factors involved in progression of adenomyosis.
Adenomyosis
Myometrium
Cite
Citations (0)
Myometrium
Luteolysis
Cite
Citations (58)
Adenomyosis
Myometrium
Cite
Citations (0)
Adenomyosis
Cite
Citations (0)