Гистологические и иммуногистохимические особенности эктопических очагов у женщин с болевым течением наружного генитального эндометриоза

Chronic pelvic pain syndrome (CPPS) is one of the most common complications of external genital endometriosis. However, taking into account the delayed diagnosis, timely therapy suffers, which leads to a progressive decrease in the quality of life of this category of patients. The formation of pain is based on a mixed pathogenetic mechanism, which includes local nociception and the development of Central sensitization syndrome, which leads to the automation of pain syndrome. Objective: to study the histological and immunohistochemicalfeatures of ectopic foci to determine the relationship of these parameters with the duration of pain. Materials and methods. The study included 135 patients of reproduc- tive age from III–IV st. of external genital endometriosis (EGE) according to the classification of R-AFS (1996): group I – 105 women with EGE and CPPS and group II – 30 women with painless course of EGE. All the patients were performed laparoscopic surgery with macroscopic assessment of ectopic lesions with subsequent excision. The obtained material was subjected to histological and immunohistochemical (IGH) examination. Results. In women with EGE complicated with CPPS, ectopic foci in 93,3% looked brownish-cyanotic color with a high concentration ofT- (40*) and B-lymphocytes (79*) in them (p<0,05), whereas in patients with pain- free course of EGE visually more often were red (50%) and white (30%) foci, and brownish-cyanotic only 20%, and the concentration of T- (11*) and B-lymphocytes (15*) were significantly less (p<0,05) (*abs. number of cells in the field of view). Conclusion.Thedataobtainedconfirmandcomplementthemechanisms of local inflammation formation in ectopic foci, which is a starting point in the formation of pain syndrome at the peripheral level. Macroscopic features of ectopic foci (predominance of brownish-bluish color) can be- come a marker of the duration of pain and its progression.