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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (1): 73-78    DOI: 10.31083/j.ceog.2021.01.2192
Original Research Previous articles | Next articles
The infiltrating ability of abdominal wall endometriosis is associated with ectopic endometrial glandular activity
Xiao Zhang1, , Ying-Ying He2, , Nan Jiang3, Zhi-Gang Sun3, Feng Yan3, Cidanyangzong4, Fang Long4, Fang-Xin Shi5, Xiao-Guang Xu6, *(), Zhen Xiao5, 7, *()
1Department of Obstetrics and Gynecology, First Affiliated Hospital of Dalian Medical University, Dalian, 116000 Liaoning; Institute of High Altitude Medicine, People's Hospital of Naqu affiliated to Dalian Medical University, P. R. China
2Department of Pathology, Dalian Maternal and Children Health Care Hospital, Dalian, 116000 Liaoning, P. R. China
3Department of Pathology, First Affiliated Hospital of Dalian Medical University, Dalian, 116000 Liaoning, P. R. China
4Department of Obstetrics and Gynecology, Institute of High Altitude Medcine, People's Hospital of Naqu affiliated to Dalian Medical University, 852000 Tibet, P. R. China
5Department of Obstetrics and Gynecology, First Affiliated Hospital of Dalian Medical University, Dalian, 100086 Liaoning, P. R. China
6Institute of High Altitude Medicine, People's Hospital of Naqu affiliated to Dalian Medical Univeristy, 852000 Tibet, P. R. China
7Department of Obstetrics and Gynecology, Institute of High Altitude Medicine, People's Hospital of Naqu affiliated to Dalian Medical University, Naqu, 852000 Tibet, P. R. China
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Abstract  
Introduction: The infiltration pattern of endometriosis is one of the most important pathophysiological features of this lesion. Recent studies indicate the infiltrating nature of endometriosis is associated with a lesion's genetic characteristics. However, related research regarding abdominal wall endometriosis (AWE) is limited. The aim of this study is to investigate whether AWE lesions with different infiltrating depth have different clinical and pathological features. Material and methods: A retrospective review of all cases of surgically excised AWE from 2001 to 2018 was performed from the records at Dalian Medical University and its affiliated hospitals. Descriptive data were collected and analyzed. Hematoxylin-eosin stained (H&E) slides were re-evaluated by pathologists for the density of ectopic endometrial glands (DOG). Results: Ninety-one cases were included in this study. Cases were divided into three types according to the depth of infiltration of the lesion: the fascia type (38 cases), the muscle type (40 cases) and the peritonieum type (13 cases). The primary analysis showed that mass size (P = 0.009), serum CA125 levels (P = 0.04) and operation time (P = 0.02) were significantly different among the three groups. Analysis showed that the diameter of the lesion was positively correlated with the infiltrating depth of the lesion, as well as the level of serum CA125 and the operation time. Even for lesions larger than 3 cm, serum CA125 levels and operation time still showed positive correlation with the lesion diameter (P = 0.02 and P < 0.01, respectively). Further histological research indicated that ectopic endometrial glands in deep lesions were more active and had higher density compared to masses in the superficial layers. Conclusion: This study suggests the three types of AWEs have different clinical and pathological features. When a lesion infiltrates deep into the abdominal wall, it has a larger size, is associated with increased serum CA125 levels, and needs longer time for surgical excision. The different infiltrating ability of AWEs is associated with different activities of ectopic endometrial glands.
Key words:  Abdominal wall endometriosis      Infiltrating ability      Glandular activity     
Submitted:  13 February 2020      Revised:  18 June 2020      Accepted:  06 August 2020      Published:  15 February 2021     
Fund: 
2019-BS-073/Natural Science Funds of Liaoning
ZYYD202000006/Tibet Local Science and Technology Project guided by Central Government
*Corresponding Author(s):  drxgxu@163.com (Xiao-Guang Xu); seriousdoc@163.com (Zhen Xiao)   
About author:  These authors contributed equally.

Cite this article: 

Xiao Zhang, Ying-Ying He, Nan Jiang, Zhi-Gang Sun, Feng Yan, Cidanyangzong, Fang Long, Fang-Xin Shi, Xiao-Guang Xu, Zhen Xiao. The infiltrating ability of abdominal wall endometriosis is associated with ectopic endometrial glandular activity. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 73-78.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.01.2192     OR     https://ceog.imrpress.com/EN/Y2021/V48/I1/73

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