Modern treatment of endometrial local hyperplastic processes from positions of the pathogenic approach

Authors

DOI:

https://doi.org/10.18370/2309-4117.2020.52.28-32

Keywords:

intrauterine pathology, endometrial local hyperplasia, endometrial polyposis, uteroscopy, immune histochemical study, cytokines

Abstract

Purpose of research: to improve the treatment effectiveness of patients with endometrial local hyperplasia by use of endoscopic technologies and pathogenetical postoperative therapy.

Materials and methods. 66 women whose treatment algorithm included 4 stages (hysteroscopic polyp ablation followed by the morphological study, hormonal therapy aimed at the endometrium suppression, hormonal status optimization and dispensary observation within 5 years) were the subject of the study. After complex examination and histological verification of endometrial polyposis diagnosis patients were divided into two groups: A (n = 34) with the immune corrective therapy and B (n = 32). Examination algorithm included the endometrial immune histochemical examination with its immune histochemical profile definition.

Study results. Histological screening of endometrium state resulted that 9 (26.5%) patients in the A group had the chronic endometritis features. The corresponding index for the B group stood for 15 patients (46.9%) that is 20.4% higher compared to the A group. Estrogen receptors expression with the background of progestogen treatment indicated the 1.2 times lowering for both groups. The viral and bacterial complex screening indicated the endometrial pathogenic contamination dramatic decrease. Study of tumor necrosis factor’s level determined the straightforward tendency with the CD 138 index dynamics. In a year term the complete treatment effect in A group was observed among 29 patients (85.2%), and the endometrial polyposis recurrence was observed among 5 (14.8%) patients.

Conclusions. It is necessary to take into account the woman’s age, joint genital and somatic pathology’s presence and the immune histochemical profile of hyperplastic endometrial while determining the endometrial pathology differentiated treatment tactics. Additional immune corrective therapy with the antibacterial treatment determines the receptor phenotype restoration, normalization of tumor necrosis factor-α lever and increases the endometrial polyposis treatment effectiveness up to 22.7%.

Author Biographies

V. O. Benyuk, Bogomolets National Medical University, Kyiv

MD, professor, head of the Obstetrics and Gynecology Department No. 3

Y. V. Kravchenko, Bogomolets National Medical University, Kyiv

Graduate student, Obstetrics and Gynecology Department No. 3

T. V. Kovaliuk, PhD, assistant professor, Obstetrics and Gynecology Department No. 3

PhD, assistant professor, Obstetrics and Gynecology Department No. 3

S. V. Beniuk, Bogomolets National Medical University, Kyiv

PhD, assistant professor, Obstetrics and Gynecology Department No. 3

I. A. Usevych, Bogomolets National Medical University, Kyiv

PhD, assistant professor, Obstetrics and Gynecology Department No. 3

References

  1. Artymuk, N.V., Guljaeva, L.F., Zotova, O.A. “Features of metabolism and estrogen reception in hyperplastic processes of the endometrium and endometriosis.” Mother and Baby in Kuzbass 1 (2012): 8−12.
  2. Benyuk, V.A., Goncharenko, V.N., Zabudskij, A.V., et al. Intrauterine pathology. Kyiv. Zdorov'e Ukrainy (2013): 206 p. Бенюк, В.А.
  3. Benyuk, V.A., Goncharenko, V.M. “Clinical and morphological justification of the differential algorithm for the treatment of endometrial hyperplastic processes in women of reproductive age.” Ohrana materinstva i detstva 1.23 (2014): 17–21. Бенюк, В.A.
  4. Benyuk, V.O., Makarenko, M.V., Dyndar, O.A., et al. Algorithms in obstetrics and gynecology. Kyiv. Doktor-Medіa Ltd (2016): 510 p.
  5. Benyuk, V.O., Usevich, І.A. Nikoniuk, T.R. “New methods of treatment of endometrial hyperplastic processes.” In: Collection of scientific works Association of Obstetricians-Gynecologists of Ukraine. Kyiv. Poligraf plus (2012): 32–5.
  6. Vdovychenko, Y.P., Goljanovskyj, O.V, Lopushan, I.P. “Hyperplasia of the endometrium processes: terminology etiopatogenia, diagnosis, treatment.” Zhinoche zdorovja 6.30 (2012): 12−9.
  7. Goncharenko, V.M. Hyperplastic processes of the endometrium. Prognosis, diagnosis, treatment and rehabilitation. Thesis abstract for MD degree. Kyiv. Bogomolets National Medical University (2017): 39 p. Гончаренко, В.М.
  8. Goncharenko, V.M., Benyuk, V.O., Kalenska, O.V., Strokan, A.M. “Immunohistochemical study of the interaction of endometrial apoptosis with the state of the APUD system in normal and pathological conditions.” Health of woman 1.107 (2016): 63–7.
  9. Goncharenko, V.M., Rosha, L.G., Tibin, Y.V., Kalenska, O.V. Organization and conduct of immunohistochemical studies. Guidelines. Kyiv (2015): 33 p.
  10. Zhuk, S.I. “Algorithms for assisting with abnormal uterine bleeding.” Female doctor 4 (2015): 22–31.
  11. Tatarchuk, T.F., Kalugina, l.V., Tutchenko, T.N. “Hyperplastic processes of endometrium: what's new? “Reproductive endocrinology 5.25 (2015): 7–13.
  12. Zaporozhan, V.N., Tatarchuk, T.F., Dubinina, V.G., Kosei, N.V. “Modern diagnostics and treatment of endometrial hyperplastic processes.” Reproductive endocrinology 1.3 (2012): 5−12. DOI: 10.18370/2309-4117.2012.3.5-12
  13. Zadonskaja, Y.N., Chernyshova, A.L., Kolomiec, L.A., Bochkareva, N.V. “Immunohistochemical prognosis criteria for endometrial cancer.” Sibirskij onkologičeskij žurnal 1.37 (2010): 79–84.
  14. Lysenko, O.V., Zanko, S.N. “Endometrial hyperplastic processes in different age periods: study of cytokine status and SFAS-ligand content.” Obstetrics and Gynecology 4 (2011): 63−8.
  15. Makarov, I.O., Ovsyannikova, T.V., Sheshukova, N.A. “Oncological aspects of hyperplastic processes in the endometrium.” Rossiyskiy vestnik akushera-ginekologa 1 (2011): 13−6.
  16. Parashchuk, Y.S., Kalinovska, O.I., Gryshchenko, M.G., Parashchuk V.Y. Infertility in marriage: a study guide. Kharkiv. KhNMU (2014): 124 p.
  17. Pashov, A.I., Tshaj, B.B., Dyhno, Y.A. Proliferative processes of the endometrium: pathogenesis, prognosis, early diagnosis. Monograph. Novosibirsk. Nauka (2013): 258 p.
  18. Tatarchuk, T.F., Kalugina, L.V. “On the question to treatment of endometrial hyperplastic processes.” Reproductive endocrinology 2.4 (2012): 88−92. DOI: 10.18370/2309-4117.2012.4.88-93
  19. Tatarchuk, T.F., Kalugina, L.V. “Endometrial polyps. Is preventive treatment necessary?” Reproductive endocrinology 2.10 (2013): 69–75. DOI: 10.18370/2309-4117.2013.10.69-75
  20. Tatarchuk, T.F., Kovalenko, E.P., Filonenko, T.G., Kubyshkin, A.V. “Expression of steroid hormone receptors and levels of estrogen and progesterone in uterine washes of women with endometrial hyperplasia.” Health of woman 6.62 (2011): 105−10.
  21. Tuchkina, I.A., Gilenko, Z.O., Kalashnik, N.V., Vygovskaja, L.A. “Clinical and hormonal characteristics and therapy of girls with endometrial hyperplasia on the background of anemia.” International Medical Journal 3 (2014): 87−91.
  22. Sheshukova, I.O., Makarov, I.O., Borovkova, E.I. “Prognostic factors for the development of hyperplastic processes in the endometrium during perimenopause.” Rossiyskiy vestnik akushera-ginekologa 11.4 (2011): 13−6.
  23. Annan, J., Aquilina, J., Ball, E. “The management of endometrial polyps in the 21st century.” The Obstetrician & Gynaecologist 14 (2012): 33–8.
  24. Lenci, M.A., Nascimento, V.A., Grandini, A.B., et al. “Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy.” Einstein (SaoPaulo) 12 (2014): 16–21.
  25. Morotti, M., Menada, M.V., Moioli, M. “Frozen section pathology at time of hysterectomy accurately predicts endometrial cancer in patients with preoperative diagnosis of atypical endometrial hyperplasia.” Gynecol Oncol 125.3 (2012): 536−40.

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Published

2020-05-13

How to Cite

Benyuk, V. O., Kravchenko, Y. V., Kovaliuk, T. V., Beniuk, S. V., & Usevych, I. A. (2020). Modern treatment of endometrial local hyperplastic processes from positions of the pathogenic approach. REPRODUCTIVE ENDOCRINOLOGY, (52), 28–32. https://doi.org/10.18370/2309-4117.2020.52.28-32

Issue

No. 52 (2020)

Section

Tumors and pretumoral pathology

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Copyright (c) 2020 V. O. Benyuk, Y. V. Kravchenko, T. V. Kovaliuk, S. V. Beniuk, I. A. Usevych

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