消化系统浸润性子宫内膜异位症（DSIE）是消化系统中罕见的一种子宫内膜异位症形式。DSIE通常发生在肠道（尤其是乙状结肠直肠）、肝脏、胆囊和胰腺。临床上，DSIE呈现出与子宫内膜异位症相同的症状，包括周期性疼痛、出血和不孕，此外还伴有特殊的胆道/肠道梗阻和胃肠道出血。与一般的子宫内膜异位症相比，DSIE具有独特的生物行为和病理生理机制。大多数DSIE是深层浸润性子宫内膜异位症，其特点包括转移至淋巴结和淋巴血管、血管生成、外周神经补充、纤维化和侵袭周围组织。DSIE相关的外周血管生成分为三个模式：血管生成、血管发生和血管吻合。这些模式受多种缺氧-激素细胞因子之间的相互作用调控。神经生长因子调节DSIE病灶中的大量神经纤维束的增加，这解释了深层疼痛的严重症状。它们还与纤维化和DSIE的侵袭性相关。DSIE病灶中的周期性变化、反复出现的炎症和氧化应激促进了病灶中的反复组织损伤和修复（ReTIAR）机制，加速纤维蛋白束形成和与癌症相关的突变。与恶性肿瘤类似，DSIE也可以显示出由E-钙粘蛋白和N-钙粘蛋白介导的集体细胞迁移引起的侵袭性。这常常导致DSIE在临床实践中被误诊为消化系统的恶性肿瘤。除手术外，迫切需要新型治疗方法以有效根除这种病灶。 © 2023 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.

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.© 2023 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.