Prevalence and risk factors of adenomyosis at hysterectomy

Bergholt, Thomas; Eriksen, Lena Mariann; Berendt, N.; Jacobsen, Morten; Hertz, J. B.

doi:10.1093/humrep/16.11.2418

Cited by 187 publications

(163 citation statements)

References 17 publications

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“…12 This wide range reflects differences in patient population, histopathological criteria used to diagnose adenomyosis and the diligence with which pathology specimens are examined. [13][14][15] The histological prevalence of adenomyosis in our study falls within the reported range; however the actual prevalence may have been over or under estimated depending on how thoroughly the pathologists examined the hysterectomy specimens.…”

Section: Discussionsupporting

confidence: 62%

“…2 Uterine enlargement, dysmenorrhoea and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. 3,4 It is relatively frequent in multiparous women, in their fourth and fifth decade of life. 5 Risk factors for adenomyosis are age, multiparity, surgical disruption of the endometrial-myometrial border, elevated levels of both FSH and prolactin, smoking habits and history of depression.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and ultrasonological features of adenomyosis and its histopathological correlation

Gupta

Goel

Agrawal

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Clinical and ultrasonological features of adenomyosis and its histopathological correlation

Gupta

Goel

Agrawal

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…Treatment of adenomyosis has been a challenge, with hysterectomy being the treatment of choice for severe and symptomatic adenomyosis (2). Hitherto, the molecular mechanisms underlying adenomyosis-associated dysmenorrhea are poorly understood.…”

Section: Anxa2 Knockdown Compromises Growth Metastasis and Proangiomentioning

confidence: 99%

“…It preferentially inflicts multiparous women in their reproductive or perimenopausal years, and its prevalence worldwide has been reported to range from 8.8 to 61.5% in women at the time of hysterectomy (1,2). Approximately two-thirds of adenomyosis patients suffer from dysmenorrhea (15-30%), menorrhagia (40 -50%), metrorrhagia (10 -12%), or even early pregnancy stage miscarriages, thereby greatly compromising their physical, mental, and social well being.…”

mentioning

confidence: 99%

Proteomics Identification of Annexin A2 as a Key Mediator in the Metastasis and Proangiogenesis of Endometrial Cells in Human Adenomyosis

Zhou

et al. 2012

Molecular & Cellular Proteomics

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Adenomyosis is a common estrogen-dependent disorder of females characterized by a downward extension of the endometrium into the uterine myometrium and neovascularization in ectopic lesions. It accounts for chronic pelvic pain, dysmenorrhea, menorrhagia, and infertility in 8.8 -61.5% women worldwide. However, the molecular mechanisms for adenomyosis development remain poorly elucidated. Here, we utilized a two-dimensional polyacrylamide gel electrophoresis/MS-based proteomics analysis to compare and identify differentially expressed proteins in matched ectopic and eutopic endometrium of adenomyosis patients. A total of 93 significantly altered proteins were identified by tandem MS analysis. Further cluster analysis revealed a group of estrogen-responsive proteins as dysregulated in adenomyosis, among which annexin A2, a member of annexin family proteins, was found up-regulated most significantly in the ectopic endometrium of adenomyosis compared with its eutopic counterpart. Overexpression of ANXA2 was validated in ectopic lesions of human adenomyosis and was found to be tightly correlated with markers of epithelial to mesenchymal transition and dysmenorrhea severity of adenomyosis patients. Functional analysis demonstrated that estrogen could remarkably up-regulate ANXA2 and induce epithelial to mesenchymal transition in an in vitro adenomyosis model. Enforced expression of ANXA2 could mediate phenotypic mesenchymal-like cellular changes, with structural and functional alterations in a ␤-catenin/T-cell factor (Tcf) signaling-associated manner, which could be reversed by inhibition of ANXA2 expression. We also proved that enforced expression of ANXA2 enhanced the proangiogenic capacity of adenomyotic endometrial cells through HIF-1␣/VEGF-A pathway. In vivo, we demonstrated that ANXA2 inhibition abrogated endometrial tissue growth, metastasis, and angiogenesis in an adenomyosis nude mice model and significantly alleviated hyperalgesia. Taken together, our data unraveled a dual role for ANXA2 in the pathogenesis of human adenomyosis through conferring endometrial cells both metastatic potential and proangiogenic capacity, which could serve as a potential therapeutic target for the treatment of adenomyosis patients.

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“…In hysterectomy specimens the incidence of adenomyosis reported in the literature varies, ranging from a high of 61.5% to a low of 8.8% (2,5,(11)(12)(13)(14)(15). Hyperestrogenemia, a cause of endometrial hyperplasia and fibroid growth, has been associated with adenomyosis, (5,11) as has prior pregnancy (2,3,13,15,16). Adenomyosis has also been related to the presence of endometriosis (2,(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Adenomyosis a variant, not a disease? Evidence from hysterectomized menopausal women in the Study of Women's Health Across the Nation (SWAN)

Weiss

Maseelall

Schott

et al. 2009

Fertility and Sterility

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Objective-Our study evaluates the symptoms commonly attributed to adenomyosis in women undergoing the menopausal transition. We hypothesized that adenomyosis is more commonly seen in women with fibroids, pelvic pain, abnormal uterine bleeding, and in the presence of endometriosis. Design-Retrospective cohortSetting-multi-site community based study Patients-SWAN study enrollees who had hysterectomies Interventions-None Main Outcome Measurements-Relationship of Adenomyosis to other entitiesResults-Adenomyosis was found in 48% of 137 patients. Frequencies of presenting symptoms were similar in those with and without evidence of adenomyosis. The same prevalence of fibroids, 37 % versus 43% (p=0.39), endometriosis, 3% versus 5% (p=0.41), abnormal bleeding, 27% versus 33% (p=0.72), or chronic pelvic pain in the presence of fibroids 12% versus 17%, (p=0.58), was seen in the presence or absence of adenomyosis.Conclusions-Adenomyosis is a common diagnosis seen in hysterectomized specimens from women undergoing the perimenopausal transition. Adenomyosis is equally common in women who also have fibroids, endometriosis, pelvic pain, or abnormal uterine bleeding, and those women that do not. Therefore, adenomyosis is an incidental finding, not the source of the symptomatology. It appears not to be a "disease" per se, but a normal variant.

show abstract

Prevalence and risk factors of adenomyosis at hysterectomy

Abstract: Our study stresses the need for precise diagnostic criteria for adenomyosis, and furthermore indicates that endometrial hyperplasia and adenomyosis may have a common aetiology.

Cited by 187 publications

References 17 publications

Clinical and ultrasonological features of adenomyosis and its histopathological correlation

Clinical and ultrasonological features of adenomyosis and its histopathological correlation

Proteomics Identification of Annexin A2 as a Key Mediator in the Metastasis and Proangiogenesis of Endometrial Cells in Human Adenomyosis

Adenomyosis a variant, not a disease? Evidence from hysterectomized menopausal women in the Study of Women's Health Across the Nation (SWAN)

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