Genetic factors Familial clustering of endometriosis is a common clinical observation In families with endometriosis the disease is often confined to the maternal line, and is 7 times more common in first-degree relatives than in the general population In future studies, evaluation of dNa polymorphism may identify specific genes involved in the development of endometriosis 2003-11-3 6
2003-11-3 6 Genetic factors： • Familial clustering of endometriosis is a common clinical observation. • In families with endometriosis，the disease is often confined to the maternal line，and is 7 times more common in first-degree relatives than in the general population. • In future studies，evaluation of DNA polymorphism may identify specific genes involved in the development of endometriosis
Immunologic Theory: Lose control of immunologic balance Both cellular immunity and humoral immunity change 1) Macrophage↑- release l-1、IL6、TNF、EGF、 FGF etc.- stimulate t b lymphocyte proliferation and activation 2) Activity of killer cell (nK cell and T cell) 3)Produce anti-endometrium antibody 4) Abnormal expression of CAMs(cell adhesion molecules 2003-11-3
2003-11-3 7 Immunologic Theory： • Lose control of immunologic balance • Both cellular immunity and humoral immunity change. 1) Macrophage↑ release IL–1、IL–6、TNF、EGF、 FGF etc. stimulate T、B lymphocyte proliferation and activation 2) Activity of killer cell（NK cell and T cell）↓ 3) Produce anti–endometrium antibody 4) Abnormal expression of CAMs（cell adhesion molecules）
The pathogenesis Is unclear multifactor 2003-11-3
2003-11-3 8 • The pathogenesis is unclear. • multifactor
Pathology macroscopic appearance (1): The commonest sites 1. Ovary chocolate cyst) 2. Peritoneum of the recto-vaginal cul-de- sac of the pouch of douglas 3. Utero-sacral ligaments 4. Sigmoid colon 5. Broad ligament 2003-11-3
2003-11-3 9 Pathology – macroscopic appearance（1）： • The commonest sites： 1. Ovary（chocolate cyst） 2. Peritoneum of the recto–vaginal cul–de– sac of the Pouch of Douglas 3. Utero–sacral ligaments 4. Sigmoid colon 5. Broad ligament
This is a section through an enlarged 12 cm ovary to demonstrate a cystic cavity filled with old blood typical for endometriosis with formation of an endometriotic. or chocolate, cyst 2003-11-3
2003-11-3 10 This is a section through an enlarnged 12 cm ovary to demonstrate a cystic cavity filled with old blood typical for endometriosis with formation of an endometriotic, or "chocolate", cyst