Digestive system deep infiltrating endometriosis: What do we know

Wenze Yin; Xiaoqing Li; Peng Liu; Yingjie Li; Jin Liu; Shan Yu; Sheng Tai

doi:10.1111/jcmm.17921

Digestive system deep infiltrating endometriosis: What do we know

Wenze Yin, Xiaoqing Li, Peng Liu, Yingjie Li, Jin Liu, Shan Yu, Sheng Tai

Journal of cellular and molecular medicine · 2023 · vol. 27(23) , pp. 3649–3661 · doi:10.1111/jcmm.17921 · PMID:37632165 · W4386188223

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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Deep infiltrating endometriosis of the digestive system exhibits unique biological behaviors including metastasis, angiogenesis, nerve recruitment, and fibrosis, often leading to misdiagnosis as malignancy.

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Abstract

Digestive system infiltrating endometriosis (DSIE) is an uncommon form of endometriosis in the digestive system. DSIE often occurs in the intestines (especially the sigmoid rectum), liver, gallbladder and pancreas. Clinically, DSIE presents with the same symptoms as endometriosis, including cyclic pain, bleeding and infertility, in addition to specific biliary/intestinal obstruction and gastrointestinal bleeding. Compared to general endometriosis, DSIE has unique biological behaviour and pathophysiological mechanisms. Most DSIEs are deep invasive endometrioses, characterized by metastasis to the lymph nodes and lymphatic vessels, angiogenesis, peripheral nerve recruitment, fibrosis and invasion of surrounding tissues. DSIE-related peripheral angiogenesis is divided into three patterns: angiogenesis, vasculogenesis and inosculation. These patterns are regulated by interactions between multiple hypoxia-hormone cytokines. The nerve growth factors regulate the extensive neurofibril recruitment in DSIE lesions, which accounts for severe symptoms of deep pain. They are also associated with fibrosis and the aggressiveness of DSIE. Cyclic changes in DSIE lesions, recurrent inflammation and oxidative stress promote repeated tissue injury and repair (ReTIAR) mechanisms in the lesions, accelerating fibril formation and cancer-related mutations. Similar to malignant tumours, DSIE can also exhibit aggressiveness derived from collective cell migration mediated by E-cadherin and N-cadherin. This often makes DSIE misdiagnosed as a malignant tumour of the digestive system in clinical practice. In addition to surgery, novel treatments are urgently required to effectively eradicate this lesion.

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Condition tags

mesh:D004715endometriosisdie_deep_infiltratinginfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Female Female Female

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References (100)

Cited by (10)

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