国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (6): 624-628.doi: 10.12280/gjfckx.20250663

• 普通妇科疾病及相关研究:综述 • 上一篇    下一篇

子宫内膜息肉发病机制研究进展

赵瑞昆, 周勤()   

  1. 400016 重庆医科大学附属第一医院妇科
  • 收稿日期:2025-06-17 出版日期:2025-12-15 发布日期:2025-12-30
  • 通讯作者: 周勤 E-mail:zhqinou@hospital.cqmu.edu.cn

Research Progress on the Pathogenesis of Endometrial Polyps

ZHAO Rui-kun, ZHOU Qin()   

  1. Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Received:2025-06-17 Published:2025-12-15 Online:2025-12-30
  • Contact: ZHOU Qin E-mail:zhqinou@hospital.cqmu.edu.cn

摘要:

子宫内膜息肉(endometrial polyp,EP)是子宫内膜局部腺体和间质过度增生形成的良性病变,常表现为异常子宫出血和不孕,其发生机制尚未完全阐明。目前研究表明,EP发病机制较为复杂,相关机制主要涉及:激素与代谢失衡,表现为局部雌激素优势和胰岛素抵抗协同促进内膜增殖并抑制凋亡;细胞异常增殖与凋亡,导致细胞逃逸程序性死亡;炎症微环境改变,核因子κB(nuclear factor-κB,NF-κB)通路异常激活及其下游效应分子功能紊乱,并与慢性子宫内膜炎共存;遗传异常,RAS基因突变驱动息肉生长,Wnt信号通路激活进一步驱动息肉克隆增殖与血管异常;生殖道微生态失调,病原体上行感染,导致子宫内膜异常修复与增生,参与EP发病。提示EP是多因素、多信号通路调控的结果。

关键词: 息肉, 子宫内膜肿瘤, 子宫内膜炎, 激素类, 炎症, 遗传, 微生物群

Abstract:

Endometrial polyps (EP) are benign lesions formed by the excessive proliferation of local glands and stroma in the endometrium. They often present as abnormal uterine bleeding and infertility, and the pathogenesis has not been fully elucidated. Current research shows that the pathogenesis of EP is relatively complex, and the relevant mechanisms mainly involve: hormonal and metabolic imbalances, manifested as local estrogen dominance and insulin resistance synergistically promoting endometrial proliferation and inhibiting apoptosis; abnormal cell proliferation and apoptosis, leading to cells escaping programmed death; changes in the inflammatory microenvironment, with abnormal activation of the nuclear factor-κB (NF-κB) pathway and dysfunction of its downstream effector molecules, and co-existence with chronic endometritis; genetic abnormalities, where RAS gene mutations drive polyp growth, and activation of the Wnt signaling pathway further drives polyp clonal proliferation and vascular abnormalities; dysregulation of the genital tract microbiota, where ascending infection by pathogens leads to abnormal repair and hyperplasia of the endometrium and participates in the pathogenesis of EP. This indicates that EP is the result of multifactor and multi-signaling pathway regulation.

Key words: Polyps, Endometrial neoplasms, Endometritis, Hormones, Inflammation, Heredity, Microbiota