Pathogenesis of bowel endometriosis

Area of Science:

• Gynecologic Pathology
• Surgical Pathology
• Molecular Pathology

Background:

• Bowel endometriosis pathogenesis is complex, with a predilection for the rectum/sigmoid colon due to anatomical factors.
• Deep bowel endometriosis exhibits invasion, angiogenesis, fibrosis, and interactions with nerves, oxidative stress, and the microbiome.

Purpose of the Study:

• To elucidate the multifactorial pathogenesis of bowel endometriosis.
• To explore the molecular and genetic underpinnings of deep bowel endometriosis.
• To discuss potential future classification based on molecular features.

Main Methods:

• Review of existing literature on bowel endometriosis pathogenesis.
• Analysis of pathological features including invasion, angiogenesis, and fibrosis.
• Inclusion of emerging research on oxidative stress, microbiome, neurogenesis, and genetic mutations.

Main Results:

• Anatomical factors favor sigmoid colon and rectal involvement.
• Pathological hallmarks include invasion, angiogenesis, fibrosis, and neurogenesis.
• Somatic cancer driver mutations (e.g., KRAS) are identified in deep bowel endometriosis.

Conclusions:

• Bowel endometriosis pathogenesis is multifactorial, involving anatomical, cellular, and molecular processes.
• Neurogenesis and genetic mutations may play significant roles in disease progression.
• Future classification of bowel endometriosis may be based on molecular characteristics.