Role of the endometrium immunehistochemical profile in treatment of reproductive and pre-menopausal patients with endometrium ordinary hyperplasia
Keywords:endometrium hyperplastic processes, immunohistochemistry, endometrium receptor systems, EC-cells
Aim of the study – improvement of the treatment effectiveness of patients with the endomentrium ordinary hyperplasia by development and implementation of the treatment algorithm with consideration endometrium immune histochemical profile specific features.
Methods and material. 203 women of reproductive and pre-menopause age with the endometrium ordinary hyperplasia were examined and treated. Receptor phenotype, apoptosis processes state and the levels of the diffuse endocrine system (APUD) activation in hyperplastic endometrium were investigated with immune histochemical method. On the basis of obtained results the method of hormonal therapy with consideration the state of the receptors systems and apoptosis level activation and the level of the APUD-system of hyperplastic endometrium activation’s was developed and offered; it was used in the treatment of 107 women with the endometrium ordinary hyperplasia. The experimental group composed of 96 women with the endometrium ordinary hyperplasia who were treated by the hormonal therapy (receptors state was not taken into account).
Study results. Analysis of the obtained data gave the grounds to state that the progestine resistant form of the pathological process was observed in 13.1% reproductive age women with non-atypical endometrium ordinary hyperplasia and in 18.5% pre-menopause age patients. It was stated that the hormonal therapy with taken into account the receptor phenotype allows to improve its effectiveness (up to 24.0% for reproductive age women and 20.6% for pre-menopause age).
Conclusions. Detection of immunohistochemical endometrial profiles reduce expression of progesterone receptors below 100 points scale HISTOScore, increasing antiapoptosis protein Bcl-2 above 2.4 points and increase the number of EC-cells of endometrium APUD-system above 4.8 in view indicates progestin-insensitive form of hyperplastic process and need individualized treatment strategy using gonadotropin-releasing hormone.
Individual approach in treatment of patients with the endomentrium hyperplastic processes taken into consideration the immunehistochemical profile indexes allows to improve the treatment, avoid regression, improve the therapy results, set category of patients with contraindications to hormone therapy and to prove the feasibility of surgical treatment.
- Beniuk, V.A., Goncharenko, V.N., Kuvita, Y.V., et al. Intrauterine pathology: manual for doctor “Gynecologist”. Guideline. Kyiv. Library “Health of Ukraine” (2013): 203 p.
- Dubinina, V.G., Bubnov, V.V., Bobrova, V.N., Anufriev, M.G. “Spontaneous chromosomal lymphocytes instability in peripheral blood in patients with endometrial cancer.” Women’s Reproductive Health 3 (2005): 187–90.
- Dubinina, V.G., Rybin, A.I. “Immuno-endocrine relations in reproductive aged women with different kinds of endometrium transformation.” Bucovina Medical Messenger 6 (2002): 214–19.
- Dubossarska, Z.M., Dubossarska, Y.A., Goncharenko, V.N., et al. Theory and practice of gynecological endocrinology. Dnipropetrovsk. PE “Lira LTD” (2005): 412 p.
- Zaporozhan, V.N., Tatarchuk, T.F., Dubinina, V.G. “Modern diagnosis and treatment of endometrial hyperplastic processes.” Reproductive Endocrinology 1.3 (2012): 32–8.
- Tatarchuk, T.F., Solskyi, Y.P. Endocrine gynecology (clinical essays): Part 1. Kyiv. Zapovіt (2003): 300 p.
- Tatarchuk, T.F., Burlaka, E.V. “Modern principles of diagnosis and treatment of endometrial hyperplastic processes.” Women’s Health 4 (2003): 107–13.
- Beniuk, V.O., Bubnov, R.V., Melnychuk, O. “Updating personalized management algorithm of endometrial hyperplasia in pre-menopause women.” EPMA Journal 7.1 (2016): A28. Available from: [http://link.springer.com/ article/10.1186/s13167-016-0054-6], last accessed Aug 15, 2016.
- Beniuk, V., Goncharenko, V., Kalenska, O., et al. “Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age.” EPMA Journal 4.24 (2013). Available from: [http://www. epmajournal.com/content/4/1/24/abstract], last accessed Aug 15, 2016.
- Goncharenko, V., Bubnov, R. “Endometrial hyperplasia in women of fertile age: persolized diagnosis and therapeutic strategy.” Conference Paper: 16th World Congress of the International Society of Gynecological Endocrinology (ISGE), Florence, Italy, March 2014. Available from: [http://gest.btcongress.it/viewAbstractPdf.php?id=2048], last accessed Aug 15, 2016.
- Vinatier, D., Cosson, M., Dufour, P. “Is endometriosis an endometrial disease?” Eur J Obstet Gynaec & Reprod Biol 91.2 (2000): 113–25.
How to Cite
Copyright (c) 2016 В. О. Бенюк, В. М. Гончаренко, О. В. Каленська, О. П. Мельничук, Т. В. Ковалюк
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.