Endometriosis

Endometriosis is a cell at the level of termination in order to pelvic pain and infertility,characterized by persistent lesions,often give young women a great deal of distress. Endometriosis is the growth function with endometriosis outside the uterine cavity, its main pathological changes of the plant for ectopic endometrium with the ovarian steroid hormone changes happen cyclical bleeding , blood, secretion of fluid and tissue debris gathered in the organization gap, the plasma and the slow absorption of hemoglobin, lesions around the infection produce similar inflammatory response, proliferation of fibrous tissue adhesions, and scarring folds. Lesions formed at brown purple spots or vesicles, and finally the formation of large and small, ranging from violet blue nodule or mass. Happen according to their different positions, can be divided into peritoneal endometriosis, ovarian endometriosis and adenomyosis.

General literature on the EMT of the research process can be broadly divided into three phases:
The first phase: in the 20th century, some 70 years ago that the classic symptoms of EMT sexual Dysmenorrhea infertility, pelvic purple nodules and ovarian chocolate cyst. And recognizing the ectopic endometrium and the endometrial reign as happened to the cyclical response to ovarian hormones. Accordingly, the clinical use of high-dose progesterone cause pseudopregnancy, as well as similar Danazol caused by menopause amenorrhea happen so that ectopic endometrial decidual-like changes, atrophy eventually happen at this stage surgery is the main means of treatment, section of the conservative debridement surgery and advanced lesions of uterine attachment add radical resection surgery, were widely used method of treatment. In order to prevent residual and recurrent lesions, but also the use of pre-and post-surgery drug combination therapy, treatment of symptoms of post-remission rate of up to 85% of pregnancy rate of 30% ~ 40%. Treatment efficacy and patient's age, disease staging and surgical techniques have a close relationship.
The second stage: this stage of the two major characteristics of first laparoscopic techniques continue to improve and perfect, as well as the universality of application, so that the early lesion of EMT further awareness and to develop a different opinion a classic treatment of the new Special are required to have the fertility of young patients with a more conservative, and look forward to therapy is also recognized by many scholars support. Laparoscopic treatment of EMT to further expand the indications to a large extent have been gradually replace conventional surgery, and obtained quite satisfactory results. Another characteristic of GnRHa in the treatment of EMT are of wide application as a whole pituitary - ovarian axis comprehensive inhibitor, in inhibiting lesion and restore normal physiological function of anatomy universal attention.
Phase III: In recent years, on endometriosis pathophysiology of basic research, new progress has been made. Early minimal disease and clinical symptoms of non-relevance, has aroused great importance to study found that patients with EMT in peritoneal fluid macrophage activity, the plant can produce a series of endometrial tissue cytokines and growth factors, these factors through autocrine and next secretion mechanism and macrophages have a close interaction between the relationship of ectopic endometrium in the peritoneum on the plant has an important role in growth and reproductive processes cytotoxicity (cytotoxicity) role. At present, the ectopic lesions have confirmed the plant and growth are dependent on the formation of new blood vessels, regulating angiogenesis in a number of growth factors such as VEGF by the extensive attention. Anti-angiogenesis has become the prevention and treatment of endometriosis, a new area. Cancer treatment and has similarities to transgenic studies of the vaccine produced partial lesions stable angiogenesis inhibitory factor, vascular endothelial cells in lesion target cells for gene therapy on normal tissue is less significant than that through the organization of antigen-specific vaccine-induced the body of active immunization, play a better role in the prevention and treatment. In addition, the recent discovery of ectopic foci of stromal cells to express high aromatase activity, local synthesis of estrogen, through the autocrine / paracrine role of estrogen play a role in the growth of lesions led to the application of aromatase inhibitors block the aromatase activity, inhibiting the development of lesions in order to further the prevention and treatment of endometriosis to provide a new way. Selective progesterone receptor inhibitors has been progress, I am sure in the near future, with the endometriosis pathophysiology of further in-depth knowledge on the prevention and treatment will achieve the desired progress.
So far, however, about the true pathophysiology EMT has not been finally clarified the mechanism to promote endometriotic plant capacity factors and growth is still unknown so far. Further from these areas to conduct in-depth research, is bound to change the current clinical treatment limited to the final stage of EMT status, the direct guidance of the clinical cure of early lesions, thereby preventing the development of the disease to the advanced.

Epidemiology:
Reported in the literature related to endometriosis the incidence of the scope can vary greatly from 1% ~ 50%, the general reported for about 15% due to different diseases and a variety of operations while the categories.
As can be seen from Table 1: In infertile women have pelvic pain as well as the history of women, endometriosis a higher rate of incidence, while at other women while their lower incidence of the General reported in the literature, is suffering from infertility disease of women in the incidence of endometriosis at 21% ~ 47%, while in childbearing women, their incidence rate of 1% ~ 5%.
Endometriosis with the exception of the incidence of infertility and pelvic pain, but also with women's age, occupation, menstrual status is closely related to endometriosis occurred in many of childbearing age to postmenopausal dissipated, and Medium rare in young women. On patients in terms of career to the cadres, teachers, technicians and more farmers and non-employed persons less research results also show that: early menarche, short menstrual cycle (≤ 27 days), passing through a long time (≥ 8 days) or menorrhagia who endometriosis increased morbidity. Of 206 cases diagnosed as endometriosis patients control analysis showed that age of menarche and the risk was a negative correlation.
Table 3 shows that when age of menarche in 13 ~ 16-year-old relative risk for one, then the age of ≤ 12-year-old RR was significantly higher than that age ≥ 17 years of age, whichever is compared, the difference there is very significant.