Vascular endothelial growth factor gene polymorphisms are associated with the risk of developing adenomyosis

Vascular endothelial growth factor (VEGF), a major mediator of angiogenesis and vascular permeability, may play a key role in the development of adenomyosis. The aim of this study was to investigate whether these four VEGF polymorphisms (?2578C/A, ?1154G/A, ?460C/T, and +936C/T) were associated with the risk of adenomyosis development. Genotypes were determined by polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) assay in 174 adenomyosis patients and 199 frequency‐matched control women. There were significant differences between patients and control group in allele frequencies and genotype distributions of the ?2578C/A polymorphisms (P = 0.010 and 0.044, respectively). Compared with the C/C genotype, the A/A + C/A genotype could significantly modify the risk of developing adenomyosis [odds ratio (OR) = 0.64, 95% confidence interval (CI) = 0.42–0.97]. For the ?1154G/A polymorphism, the allele frequencies and genotype distributions in patient group were significant different from those of the controls (P = 0.001 and 0.007, respectively). Compared with the G/G genotype, the A/A + G/A genotype could significantly decrease the risk of developing adenomyosis (OR = 0.51, 95% CI = 0.33–0.80). However, the genotype distributions and allele frequencies of the ?460C/T and +936C/T polymorphisms did not significantly differ between controls and patients (all P value > 0.05). The haplotype analysis suggested that the TGA (VEGF ?460/?1154/?2578) and CGA haplotypes exhibited a significant decrease in the risk of developing adenomyosis compared with the haplotype of TGC (OR = 0.64, 95% CI = 0.41–1.00; OR = 0.44, 95% CI = 0.21–0.93, respectively). The study indicated that the ?2578A or ?1154A allele of VEGF gene could significantly decrease the risk of adenomyosis and might be potentially protective factors for adenomyosis development. Environ. Mol. Mutagen., 2009. © 2009 Wiley‐Liss, Inc.     

The response of adenomyosis to endometrial ablation/resection

Operative hysteroscopy is a relatively new technique that hassignificantly improved the diagnosis and therapy of abnormaluterine bleeding. At first, the success of operative hysteroscopyin controlling this bleeding seemed extremely high but, withlong-term follow-up, a significant failure rate became evidentrequiring a repeat hysteroscopic procedure or a hysterectomy.Deep adenomyosis is a major cause of these failures. This paperdescribes three operative ablation techniques and relates manyof their failures to deep adenomyosis. The definition and pathophysiologyof adenomyosis are also explored. The possibility of delayingthe diagnosis of endometrial cancer under an ablation scan isdiscussed. Ultimately the depth of adenomyosis seems to correlatewith the outcome of endometrial ablation or resection. Patientswithout or with only minimal endometrial penetration of <2.5mm (superficial adenomyosis) have good results from the ablation.Patients with deep endometrial penetration of >2.5 mm (deepadenomyosis) usually have persistent problems and should beoffered hysterectomy over repeat ablation. Magnetic resonanceimaging or ultrasound may be an appropriate pre-operative screeningtool to determine the depth of adenomyosis.     

基于子宫腺肌症痛经的发病机制浅析电针、温针序贯治疗理论

探讨在众多治疗痛经有效的针灸方法中,依据子宫腺肌症痛经的发病机制,分别选用电针、温针进行序贯治疗,观察该方案对痛经远期疗效及瘤体大小的影响,为针灸治疗腺肌症痛经探索更高效的方法。     

彩色超声对子宫肌瘤与子宫腺肌病的鉴别价值

目的:分析与探讨彩色超声对于子宫肌瘤与子宫腺肌病的鉴别与诊断价值.方法:选取本院2009年4月至2011年10月期间收治的通过病理检查证实为子宫肌瘤患者共50例,子宫腺肌病患者共40例,对两种疾病患者的临床彩色超声检查结果进行回顾性分析.结果:对50例子宫肌瘤患者采取彩色超声检查,显示存在子宫肌瘤共46例,符合率为92.0％,对30例子宫腺肌病进行彩超检查,显示存在子宫腺肌病共26例,符合率为86.7％.结论:采取彩色超声对子宫肌瘤与子宫腺肌病进行诊断,具有较为可靠的诊断依据与较高的诊断价值,因此值得在临床上进行推广与应用.     

针刺治疗子宫腺肌症23例（英文）

目的:探讨针刺加TDP照射方法对于子宫腺肌症的疗效。方法:采用针刺加TDP照射方法治疗本病,选取太冲、太溪、三阴交,点刺合谷,腰腹发凉者加TDP神灯照射,并评定疗效。结果:23例患者中治愈16例,好转7例,无效0例,有效率100%。结论:针刺加TDP照射方法对于子宫腺肌症疗效显著。     

彩色多普勒超声对子宫腺肌病的诊断价值

目的:探讨彩色多普勒超声对子宫腺肌病的诊断价值。方法:采用经阴道彩色多普勒超声(TVCDS)和经腹部彩色多普勒超声(TAS)检测有痛经等症状者63例。结果:超声诊断子宫腺肌病63例。合并盆腔内膜异位症者18例。手术治疗者42例,术后经病理证实者36例,诊断符合率85.7%(36/42)。TVCDS诊断符合率89.3%(25/28),TAS诊断符合率71.4%(10/14)。结论:彩色多普勒超声检查是目前诊断子宫腺肌病的主要方法之一,其具有无创及可重复性强的特点,可作为子宫腺肌病诊断和疗效评估的常规检查项目。TVCDS及TAS联合应用可提高子宫腺肌病的超声诊断符合率。     

促血管生成素-2在子宫内膜异位性疾病中的表达及其意义

目的检测促血管生成素-2（Ang-2）在子宫内膜异位性疾病患者在位及异位内膜中的表达，并探讨其在子宫内膜异位性疾病发病的作用。方法应用逆转录聚合酶链反应（RT—PCR）技术检测Ang-2mRNA在65例子宫内膜异位症患者（内异症组）、40例子宫腺肌病患者（腺肌病组）的异住及在位内膜中的表达及在30例正常子宫内膜组织（对照组）中的表达。结果内异症组及腺肌病组的异位及在位内膜中Ang-2的表达率均高于对照组，但其表达强度与子宫内膜异位症的临床分期无明显相关性。结论子宫内膜异位症及子宫腺肌病患者的异位及在位内膜组织中Ang-2的表达增强，Ang-2在子宫内膜异位性疾病的发病过程中起到一定的促进作用。     

血管内皮生长因子在子宫内膜异位症和子宫腺肌病中的表达

目的 探讨子宫内膜异位症(EMT)和子宫腺肌病(AMS)患者异位及在位子宫内膜组织中血管内皮生长因子(VEGF)的表达及其在血管生成调控机制中的作用.方法 采用免疫组织化学SABC方法检测16例异位内膜组织、10例腺肌瘤组织、20例在位内膜组织中VEGF的表达,并和20例正常子宫内膜组织作对照.结果 VEGF在异位内膜组织(EMT,E)中阳性表达率为93.75%(15/16),强阳性表达8例;在腺肌瘤组织(AMS,A)中阳性表达率为80.00%(8/10),强阳性表达4例;于在位内膜组织(eutopic,e)中阳性表达率为55.00%(11/20),强阳性表达3例;对照组子宫内膜组织(control,C)中阳性表达率为20.00%(4/20),无强阳性表达.E A与e阳性表达比较差异有极显著性意义(P＜0.01);E A与C阳性表达比较差异有极显著性意义(P＜0.01);e与C阳性表达比较差异有显著性意义(P＜0.05).E A与e强阳性表达比较差异有显著性意义(P＜0.05);E A与C强阳性表达比较差异有极显著性意义(P＜0.01).结论 EMT、AMS异位及在位内膜组织高表达VEGF可能与EMT和AMS发生密切相关.     

Nodular Adenomyosis of the Uterus Causing Severe Groin Pain

Objectives:

To determine the cause of severe, disabling, groin pain.

Methods:

We describe in this case report 2 patients with severe groin pain. Two myoma-like masses were found on the uterus near the right round ligament. Both masses were excised via laparoscopy.

Results:

The pathology report of these 2 cases indicated adenomyosis. Both patients were asymptomatic after the procedure. Adenomyosis usually propagates in the myometrium, and the nodular shape of this pathology is rare. In patients with severe groin pain (menstrual or continuous), the gynecologist should think about both endometriosis of the round ligament and adenomyosis near the round ligament.

Conclusion:

Severe groin pain is rare but disabling. Endometriosis of the external part of the round ligament is described as a cause. In this case report, we explain that nodular adenomyosis can also be a cause.