Recent advances in clinical diagnosis and treatment of chronic endometritis
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摘要 慢性子宫内膜炎（CE）是一种持续的、低强度的子宫内膜炎症，其特征是浆细胞浸润到子宫内膜间质中影响局部微环境，但缺乏典型的临床症状，临床上既往常被忽视。近期越来越多的研究发现，CE与复发性流产及反复种植失败等不良妊娠结局密切相关，成为辅助生殖技术研究热点。本文旨在对CE的诊断与治疗新进展进行综述，为临床医生科研和临床诊治提供参考。Abstract Chronic endometritis (CE) is a persistent, low-intensity endometrial inflammation, characterized by the infiltration of plasma cells into the endometrial stroma, thereby impacting the local microenvironment. However, due to the lack of typical clinical symptoms, it has historically been neglected in clinical settings. Recently, a growing body of research has demonstrated a significant correlation between CE and adverse pregnancy outcomes, such as recurrent pregnancy loss and repeated implantation failure. This has made CE a key focus in the field of assisted reproductive technology. This review aims to synthesize the latest advancements in the diagnosis and treatment of CE, so as to provide clinical practitioners and researchers with updated references.
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Keywords
- chronic endometritis /
- clinical diagnosis /
- treat
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[1] CICINELLI E, RESTA L, NICOLETTI R, et al. Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis[J]. Human reproduction, 2005, 20(5): 1386-1389.
[2] BUZZACCARINI G, VITAGLIANO A, ANDRISANI A, et al. Chronic endometritis and altered embryo implantation: a unified pathophysiological theory from a literature systematic review[J]. Journal of assisted reproduction and genetics, 2020, 37(12): 2897-2911.
[3] MCQUEEN D B, BERNARDI L A, STEPHENSON M D. Chronic endometritis in women with recu rrent early pregnancy loss and/or fetal demise[J]. Fertility and Sterility, 2014, 101(4):1026-1030.
[4] 董鑫垚, 王蔼明. 慢性子宫内膜炎影响女性生殖结局的相关机制探讨[J]. 生殖医学杂志, 2020, 29(1): 130-134. [4] 董鑫垚, 王蔼明. 慢性子宫内膜炎影响女性生殖结局的相关机制探讨[J]. 生殖医学杂志, 2020, 29(1): 130-134. [5] 许灵波,刘海飞,王丽艳,等.慢性子宫内膜炎影响胚胎植入的机制研究进展[J]. 现代妇产科进展展,2023,32(2): 155-158. [6] 吴小华, 冯政利. 慢性子宫内膜炎的诊断及生育相关的发病机制研究进展[J].中华生殖与避孕杂志,2022,42(6): 5. [7] BAYER-GARNER I B, NICKELL J A, KOROURIAN S. Routine syndecan-1 immunohistochemistry aids in the diagnosis of chronic endometritis[J]. Archives of pathology & laboratory medicine, 2004, 128(9): 1000-1003.
[8] YANG R, DU X G, WANG Y, et al. The hysteroscopy and histological diagnosis and treatment value of chronic endometritis in recurrent implantation failure patients[J]. Archives of gynecology and obstetrics, 2014, 289(6): 1363-1369.
[9] PUENTE E, ALONSO L, LAGANÀ A S,et al. Chronic endometritis: Old problem, novel insights and future challenges[J].International journal of fertility & sterility, 2020, 13(4):250-256.
[10] CICINELLI E, HAIMOVICH S, ZIEGLER D D, et al. MUM-1 immunohistochemistry has high accuracy and reliability in the diagnosis of chronic endometritis: a multicentre comparative study with CD-138 immunostaining [J]. Journal of assisted reproduction and genetics, 2022, 39(1): 219-226.
[11] MCQUEEN D B, PERFETTO C O, HAZARD F K, et al. Pregnancy outcomes in women with chronic endometritis and recurrent pregnancy loss[J]. Fertility and sterility, 2015, 104(4): 927-931.
[12] CHEN Y Q, FANG R L, LUO Y N, et al. Analysis of the diagnostic value of CD138 for chronic endometritis, the risk factors for the pathogenesis of chronic endometritis and the effect of chronic endometritis on pregnancy: a cohort study[J]. BMC women’s health, 2016, 16(1): 60.
[13] KITAYA K, MATSUBAYASHI H, TAKAYA Y, et al. Live birth rate following oral antibiotic treatment for chronic endometritis in infertile women with repeated implantation failure[J]. American journal of reproductive immunology, 2017, 78(5): 1-8.
[14] SONG D M, FENG X D, ZHANG Q, et al. Prevalence and confounders of chronic endometritis in premenopausal women with abnormal bleeding or reproductive failure[J]. Reproductive biomedicine online, 2018, 36(1): 78-83.
[15] HIRATA K, KIMURA F, NAKAMURA A, et al. Histological diagnostic criterion for chronic endometritis based on the clinical outcome[J]. BMC women’s health, 2021, 21(1): 94.
[16] XIONG Y J, CHEN Q, CHEN C X, et al. Impact of oral antibiotic treatment for chronic endometritis on pregnancy outcomes in the following frozen-thawed embryo transfer cycles of infertile women: a cohort study of 640 embryo transfer cycles[J]. Fertility and sterility, 2021, 116(2): 413-421.
[17] SANTORO A, TRAVAGLINO A, INZANI F, et al. The role of plasma cells as a marker of chronic endometritis: a systematic review and meta-analysis[J]. Biomedicines, 2023, 11(6): 1714.
[18] RIMMER M P, FISHWICK K, HENDERSON I, et al. Quantifying CD138+ cells in the endometrium to assess chronic endometritis in women at risk of recurrent pregnancy loss: a prospective cohort study and rapid review [J]. The journal of obstetrics and gynaecology research, 2021, 47(2): 689-697.
[19] LIU Y Y, CHEN X Y, HUANG J, et al. Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure[J]. Fertility and sterility, 2018, 109(5): 832-839.
[20] CICINELLI E, VITAGLIANO A, KUMAR A, et al. Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study[J]. Fertility and Sterility, 2019, 112(1): 162-173.
[21] CICINELLI E, VITAGLIANO A, KUMAR A, et al. Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study[J]. Fertility and sterility, 2019, 112(1): 162-173.
[22] BOUET P E, EL HACHEM H, MONCEAU E, et al. Chronic endometritis in women with recurrent pregnancy loss and recurrent implantation failure: prevalence and role of office hysteroscopy and immunohistochemistry in diagnosis[J]. Fertility and sterility, 2016, 105(1): 106-110.
[23] GKROZOU F, TSONIS O, DIMITRIOU E, et al. In women with chronic or subclinical endometritis is hysteroscopy suitable for setting the diagnosis? A systematic review[J]. The journal of obstetrics and gynaecology research, 2020, 46(9): 1639-1650.
[24] TSONIS O, GKROZOU F, DIMITRIOU E, et al. Hysteroscopic detection of chronic endometritis: evaluating proposed hysteroscopic features suggestive of chronic endometritis[J]. Journal of gynecology obstetrics and human reproduction, 2021, 50(9): 102182.
[25] 熊玉晶, 徐艳文. 不孕症合并慢性子宫内膜炎的诊治[J]. 中国实用妇科与产科杂志, 2020, 36(6): 488-491. [26] RYAN E, TOLANI A T, ZHANG J Q, et al. The menstrual cycle phase impacts the detection of plasma cells and the diagnosis of chronic endometritis in endometrial biopsy specimens[J]. Fertility and sterility, 2022, 118(4): 787-794.
[27] VITALE S G, BUZZACCARINI G, RIEMMA G, et al. Endometrial biopsy: indications, techniques and recommendations. An evidence-based guideline for clinical practice[J]. Journal of gynecology obstetrics and human reproduction, 2023, 52(6): 102588.
[28] KITAYA K, TAKEUCHI T, MIZUTA S, et al. Endometritis: new time,new concepts[J]. Fertility and sterility, 2018, 110(3): 344-350.
[29] WORKOWSKI K A, BACHMANN L H, CHAN P A, et al.Sexually transmitted infections treatment guidelines, 2021[J]. MMWR recommendations and reports. 2021, 70(4):1-187.
[30] CICINELLI E, DE ZIEGLER D, NICOLETTI R, et al. Chronic endometritis: correlation among hysteroscopic, histologic, and bacteriologic findings in a prospective trial with 2190 consecutive office hysteroscopies[J]. Fertility and sterility, 2008, 89(3): 677-684.
[31] YASUO T, KITAYA K. Challenges in clinical diagnosis and management of chronic endometritis[J]. Diagnostics,2022, 12(11): 2711.
[32] WORKOWSKI K A, BACHMANN L H,CHAN P A,et al. Sexually transmitted infections treatment guidelines, 2021[J]. MMWR recommendations and reports, 2021, 70(4): 1-187.
[33] MCQUEEN D B, BERNARDI L A, STEPHENSON M D. Chronic endometritis in women with recurrent early pregnancy loss and/or fetal demise[J]. Fertility and sterility, 2014, 101(4): 1026-1030.
[34] LUCAS E S, VRLJICAK P, MUTER J, et al. Recurrent pregnancy loss is associated with a pro-senescent decidual response during the peri-implantation window[J]. Communications biology, 2020, 3(1): 37.
[35] KITAYA K, TANAKA S E, SAKURABA Y, et al. Multidrug-resistant chronic endometritis in infertile women with repeated implantation failure: trend over the decade and pilot study for third-line oral antibiotic treatment[J]. Journal of assisted reproduction and genetics, 2022,39(8): 1839-1848.
[36] LUNCAN M H, HUNIADI A, BIMBO-SZUHAI E, et al. The effectiveness of intrauterine antibiotic infusion versus oral antibiotic therapy in the treatment of chronic endometritis in patients during IVF (in vitro fertilization) procedures[J]. BMC women’s health, 2022, 22(1): 529.
[37] PANTOS K, SIMOPOULOU M, MAZIOTIS E, et al. In‐troducing intrauterine antibiotic infusion as a novel approach in effectively treating chronic endometritis and restoring reproductive dynamics: a randomized pilot study [J]. Scientific reports, 2021, 11(1): 15581.
[38] JOHNSON N P, BAIDYA S, JESSUP S O, et al. Randomised trial of lipiodol uterine bathing effect (LUBE) in women with endometriosis-related infertility[J]. Fertility & reproduction, 2019, 1(1): 57-64.
[39] KARADBHAJNE P, DZOAGBE H Y, MORE A. Plateletrich plasma (PRP) for endometrial treatment efficacy and safety in assisted reproductive technology: a comprehensive review[J]. Cureus, 2024, 16(5): 59728.
[40] 关心怡,赵春梅,鲁敏,等. 中药灌肠联合多西环素、甲硝唑治疗合并慢性子宫内膜炎的不孕患者的临床研究[J].中国当代医药,2024,31(10):84-87.
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