深子宫内膜异位症(DE)是子宫内膜异位症最严重的亚型,病变浸润邻近组织的标志。血管异常与子宫内膜异位症病变的发展有关。以及血管化如何影响DE的发病机理,特别是,是感兴趣的。本系统评价遵循PRISMA指南,以阐明和检查DE特异性血管化的证据。使用MEDLINE进行文献检索,Embase,PubMed,Scopus,CochraneCENTRAL图书馆和欧洲PubMedCentral数据库。从开始到2023年3月13日对数据库进行了搜索。共有15项研究纳入了1125名患者。DE病变高度血管化,具有比其他类型的子宫内膜异位病变更高的微血管密度(MVD),子宫内膜异位症和对照组织的在位子宫内膜。血管内皮生长因子,与浅表子宫内膜异位症相比,其主要亚型(VEGF-A)和相关受体(VEGFR-2)在DE病变中明显增加,在位子宫内膜和对照组织。孕激素治疗与DE病变的MVD显着降低有关,解释他们的治疗效果。这篇综述全面地总结了现有的文献,报告异常血管化与DE的发病机制密切相关,并为DE的医学管理提供了潜在的优先治疗目标。
Deep endometriosis (DE) is the most severe subtype of endometriosis, with the hallmark of lesions infiltrating adjacent tissue. Abnormal vascularisation has been implicated in contributing to endometriosis lesion development in general, and how vascularisation influences the pathogenesis of DE, in particular, is of interest. This systematic
review followed the PRISMA guidelines to elucidate and examine the evidence for DE-specific vascularisation. A literature search was performed using MEDLINE, Embase, PubMed, Scopus, Cochrane CENTRAL Library and Europe PubMed Central databases. The databases were searched from inception to the 13 March 2023. A total of 15 studies with 1125 patients were included in the
review. The DE lesions were highly vascularised, with a higher microvessel density (MVD) than other types of endometriotic lesions, eutopic endometrium from women with endometriosis and control tissue. Vascular endothelial growth factor, its major subtype (VEGF-A) and associated receptor (VEGFR-2) were significantly increased in the DE lesions compared to superficial endometriosis, eutopic endometrium and control tissue. Progestin therapy was associated with a significant decrease in the MVD of the DE lesions, explaining their therapeutic effect. This
review comprehensively summarises the available literature, reporting abnormal vascularisation to be intimately related to the pathogenesis of DE and presents potentially preferential therapeutic targets for the medical management of DE.