Implantation versus infiltration: the Sampson versus the endometriotic disease theory
Abstract
It has been assumed that endometriosis is a progressive disease, with growth and development of lesions being inevitable once the disease has started. The implantation and the metaplasia theories describe the mechanism of initiation of endometriotic lesions, but do not explain the different clinical manifestations of endometriosis. To explain the variable expression, growth and development of lesions into severe disease, a new endometriotic disease theory is proposed. This theory suggests that progression of endometriosis to endometriotic disease is considered similar to the onset and progression of a benign tumour. In this theory, the most important factor in the development of endometriotic disease is not the initial implantation/metaplasia, but cellular changes such as mutations. According to this theory, endometriotic disease develops from endometriotic cells that have 'escaped' the influence of protective and regulatory factors in the peritoneal fluid.
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The endometriotic disease theory postulated that genetic incidents are required for the development of typical, cystic, or deep endometriosis.
“The endometriotic disease theory (EDT) postulated (246) that genetic incidents are required for the development of typical, cystic, or deep endometriosis.”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [246]
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- Authors
- Koninckx, P. R., Barlow, D., & Kennedy, S.
- Affiliations
- John Radcliffe Hospital (GB)
- ORCID
- Kennedy, S.
- Venue
- Gynecologic and Obstetric Investigation
- Publisher
- S. Karger AG
- Published
- 1999
- Volume
- 47
- Issue
- Suppl. 1
- Pages
- 3-10
- ISSN
- 0378-7346 (ISSN-L)
- 1423-002X
- OpenAlex
- W2017568708
- Cited by
- 100
- References
- 81
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 3 · 2021: 2 · 2020: 8 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 1 · 2015: 1 · 2014: 2 · 2012: 6
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gynecologic and Obstetric Investigation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ipsen
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, disease progression, peritoneal fluid
- MeSH terms
- Animals, Endometriosis, Extracellular Space, Female, Humans, Menstruation Disturbances, Metaplasia, Peritoneum
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