Essure®植入物切除术后有症状患者的临床和组织病理学相关性:一项横断面研究。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2023-08-01 Epub Date: 2023-06-27 DOI:10.1080/13625187.2023.2218953
Alexis Trecourt, Mojgan Devouassoux-Shisheboran, Erdogan Nohuz, Emanuele Cerruto, Stephanie Moret, Doriane Hallez, Chloe Miguet-Bensouda, Gautier Chene
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引用次数: 1

摘要

目的:人们对Essure®器械的不良反应提出了许多担忧。已经提出了几种病理生理学假说,包括过敏反应、佐剂诱导的自身免疫/自身炎症综合征、重金属释放的电偶腐蚀和炎症。在本研究中,我们旨在通过对有症状的Essure®切除患者的输卵管进行组织病理学评估来关注炎症过程。材料和方法:一项横断面研究,鉴定Essure®(STTE)周围和距离植入物较远的输卵管组织中的炎症反应类型和炎症细胞特征。还研究了组织病理学和临床相关性。结果:47例STTE患者中,急性炎症发生率为6.4%(3/47)。淋巴细胞慢性炎症(42.5%,20/47)与术前疼痛评分显著升高有关(p = .03)。纤维变性43例(91.5%)。无淋巴细胞的纤维化(51.1%,24/47)在统计学上与疼痛显著减轻相关(p = .04)。在距离Essure®植入物较远的地方,10/47(21.7%)的病例中仅出现淋巴细胞慢性炎症。结论:炎症反应似乎不足以解释所有Essure相关的不良结果,这表明涉及其他生物学机制。Clinicaltrials.gov标识符:NCT03281564。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and histopathological correlations in symptomatic patients with salpingectomy for Essure® implant removal: a cross-sectional study.

Purpose: Many concerns have been raised about adverse effects related to Essure® device. Several pathophysiological hypotheses have been proposed including allergic reactions, Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants, galvanic corrosion with release of heavy metals and inflammation. In the present study, we aimed to focus on inflammation process by performing a histopathological evaluation of Fallopian tubes in symptomatic patients with Essure® removal.

Materials and methods: A cross-sectional study with identification of the type of inflammatory response and characterisation of inflammatory cells in the surrounding tubal tissue around the Essure® (STTE) and at distance from the implant. Histopathological and clinical correlations were also investigated.

Results: In the STTE from 47 cases, acute inflammation was observed in 3/47 (6.4%) cases. Chronic inflammation with lymphocytes (42.5%, 20/47) was associated with a significant higher pre-operative pain score (p = .03). Fibrosis was noted in 43/47 (91.5%) cases. Fibrosis without lymphocytes (51.1%, 24/47) was statistically associated with significant reduced pain (p = .04). At distance from the Essure® implant, only chronic inflammation with lymphocytes was present in 10/47 (21.7%) cases.

Conclusions: Inflammation response do not seem to be enough to explain all the Essure-related adverse outcomes, suggesting the involvement of other biological mechanisms.

Clinicaltrials.gov identifier: NCT03281564.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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