rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2024-27-3-198-204qkvshkrosped-711Research ArticleОБЗОРЫREVIEWSОсобенности эндометриоза у девочек-подростков: трудности диагностики и профилактика осложненийFeatures of endometriosis in adolescent girls: difficulties in diagnosis and prevention of complicationshttps://orcid.org/0000-0002-3253-4512АдамянЛейла ВладимировнаAdamyanLeila V.

Доктор мед. наук, проф., акад. РАН, гл. специалист по гинекологии Минздрава России, зав. каф. акушерства, гинекологии и репродуктивной медицины ФГБОУ ВО «Российский университет медицины» Минздрава России

e-mail: endogyn@yandex.ru, detskgyn@yandex.ru

detskgyn@yandex.ruhttps://orcid.org/0000-0002-4540-6341СибирскаяЕлена ВикторовнаSibirskayaElena V.

Доктор мед. наук, проф. каф. акушерства, гинекологии и репродуктивной медицины ФГБОУ ВО «Российский университет медицины» Минздрава России; проф. каф. акушерства и гинекологии им. акад. Г.М. Савельевой ПФ «РНИМУ им. Н.И. Пирогова»; гл. внештатный специалист гинеколог детского и юношеского возраста Минздрава МО; руководитель «Центра охраны репродуктивного здоровья подростков МО», зав. хирургическим гинекологическим отд-нием РДКБ ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»

e-mail: elsibirskaya@yandex.ru

elsibirskaya@yandex.ruhttps://orcid.org/0000-0002-9563-6815ШарковСергей МихайловичSharkovSergey M.

Доктор мед. наук, проф. каф. детской хирургии и урологии-андрологии им. проф. Л.П. Александрова ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), руководитель Московского городского Центра репродуктивного здоровья детей и подростков

e-mail: sharkdoc@mail.ru

sharkdoc@mail.ruhttps://orcid.org/0000-0002-6844-3321ПивазянЛаура ГоровнаPivazyanLaura G.

Врач-ординатор отделения оперативной хирургии ФГБУ «НИЦ акушерства, гинекологии и перинатологии им. В.И. Кулакова» Минздрава России

e-mail: laurapivazyan98@gmail.com

Resident physician of the Department of operative surgery, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Moscow, 117997, Russian Federation

e-mail: laurapivazyan98@gmail.com

laurapivazyan98@gmail.comhttps://orcid.org/0000-0001-6538-1711НахапетянЕва ДавидовнаNakhapetyanEva D.

Студентка 4 курса лечебного факультета ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России

e-mail: evandar07@gmail.com

evandar07@gmail.comhttps://orcid.org/0009-0000-9983-2437ПлатоноваЕлизавета ВикторовнаPlatonovaElizaveta V.

Студентка 4 курса лечебного факультета ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России

e-mail: elizavetaplatonovasc@gmail.com

elizavetaplatonovasc@gmail.comhttps://orcid.org/0009-0000-9983-2437КурбатоваКристина СергеевнаKurbatovaKristina S.

Студентка 4 курса лечебного факультета ФГБОУ ВО «Российский университет медицины» Минздрава России

e-mail: kristinakurbatova2003@gmail.com

kristinakurbatova2003@gmail.comФГБОУ ВО «Российский университет медицины» Минздрава России; ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова» Минздрава РоссииRussian University of Medicine; National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. KulakovФГБОУ ВО «Российский университет медицины» Минздрава России; Российская детская клиническая больница ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииRussian University of Medicine; Russian Children’s Clinical Hospital, Pirogov Russian National Research Medical University; Pirogov Russian National Research Medical UniversityГБУЗ «Морозовская детская городская клиническая больница» ДЗМ; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)Morozov Children’s Clinical Hospital; First Moscow State Medical University by I.M. SechenovФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова» Минздрава РоссииRussian University of Medicine; National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. KulakovФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииPirogov Russian National Research Medical UniversityФГБОУ ВО «Российский университет медицины» Минздрава РоссииRussian University of Medicine202407082024273198204Copyright © Адамян Л.В., Сибирская Е.В., Шарков С.М., Пивазян Л.Г., Нахапетян Е.Д., Платонова Е.В., Курбатова К.С., 20242024Адамян Л.В., Сибирская Е.В., Шарков С.М., Пивазян Л.Г., Нахапетян Е.Д., Платонова Е.В., Курбатова К.С.Adamyan L.V., Sibirskaya E.V., Sharkov S.M., Pivazyan L.G., Nakhapetyan E.D., Platonova E.V., Kurbatova K.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/711Введение

Введение. Эндометриоз — это эстрогензависимое заболевание, которое характеризуется распространением эндометриоидноподобной ткани вне полости матки. Симптомы эндометриоза появляются после менархе в подростковом возрасте, часто остаются незамеченными, что ведёт к задержке диагностики и прогрессированию болезни. Трудности диагностики эндометриоза у подростков определяются не только специфичностью клинической картины, но и отсутствием биомаркеров для выявления болезни, а также сложностью выявления начальных форм с помощью методов визуализации, таких как ультразвуковое исследование и магнитно-резонансная томография.

Цель обзора — определение возрастных особенностей эндометриоза у девочек-подростков для ранней диагностики и своевременного лечения. Эндометриоидные гетеротопии у подростков часто выглядят иначе, чем у взрослых. Для данной возрастной группы более характерны сливающиеся везикулярные или папулезные, прозрачные, красные и белые поражения, чем чёрные и синие. Золотым стандартом для подтверждения диагноза остаётся гистологическое исследование после лапароскопической операции. При микроскопическом исследовании обнаруживаются участки фиброзной, жировой, мышечной ткани, кровоизлияния, сосуды, участки кальцификации и инфильтрации многоядерными лейкоцитами, а также сочетание эндосальпингиоза и эндометриодноподобных тканей.

Заключение

Заключение. Эндометриоз является эстрогензависимым заболеванием, выявляется у более 10% женщин репродуктивного возраста. Однако зачастую симптомы заболевания остаются незамеченными в подростковом возрасте, что ведёт к его прогрессированию у женщин в будущем. Своевременная диагностика эндометриоза имеет большое значение для предотвращения осложнений и исключения бесплодия в будущем.

Участие авторов

Участие авторов:Сибирская Е.В., Адамян Л.В., Шарков С.М. — концепция и дизайн исследования;Нахапетян Е.Д., Платонова Е.В., Курбатова К.С. — подготовка материала и написание текста;Пивазян Л.Г. — редактирование.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 30

Поступила 30.04.2024Принята к печати 11.06.2024Опубликована 12.07.2024

Introduction

Introduction. Endometriosis is an estrogen–dependent disease characterized by the spread of endometrial-like tissue outside the uterine cavity. Symptoms of the disease appear after menarche, in adolescence. The symptoms of endometriosis often go unnoticed and underestimated in early age, which leads to a delay in the beginning of therapy and the progression of the disease. The difficulty of diagnosing of endometriosis in adolescents is determined not only by the specificity of the clinical picture, but also by the lack of generally accepted markers for detecting the disease, as well as the difficulty of identifying initial forms using imaging techniques such as ultrasound, MRI.

The purpose of this review is to identify the age-related features of endometriosis, especially in children and adolescents, to provide early diagnosis of the disease and timely initiation of the treatmen. Endometrial foci in adolescents look different from adults. As a rule, merging vesicular or papular, transparent, red and white lesions are more characteristic than black or blue ones for this age group. While in adult women, the foci of endometriosis are black with pronounced fibrosis. Histological examination after laparoscopic surgery remains the gold standard for confirming the diagnosis, although the results of these studies may not always correspond to each other. Microscopic examination reveals areas of fibrous, fatty, muscular tissue, hemorrhages, vessels, areas of calcification and infiltration by multinucleated leukocytes, as well as a combination of endosalpingiosis and endometriod-like tissues. Moreover, it is important to carry out differential diagnosis with chronic pelvic pain, as well as with abnormalities in development, pathologies of the gastrointestinal tract, adenomyosis.

Conclusion

Conclusion. Thus, endometriosis is an estrogen-dependent disease affecting more than 10% of women of reproductive age. However, often the symptoms of the disease go unnoticed in adolescence, which leads to the progression of the disease in the future in women. Timely diagnosis of endometriosis plays an important role in preventing the development of complications and eliminating infertility in the future.

Contribution

Contribution:Sibirskaya E.V., Adamyan L.V., Sharkov S.M. — the concept and design of the study;Nakhapetyan E.D., Platonova E.V., Kurbatova K.S. — preparation of the material, writing the text;Pivazyan L.G. — editing the text.All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: April 30, 2024Accepted: June 11, 2024Published: July 12, 2024

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The authors declare that there are no conflicts of interest present.