Прогнозирование развития рецидива эндометриоза яичников

Among all the lesions of external genital endometriosis, the leading role belongs to ovarian endometriosis, which is associated with frequent recurrences and may case infertility. Objective: reducing the risk of recurrence of the ovarian endometriosis by identifying clinical, molecular and biological characteristics. Material and methods: we retrospectively analyzed 147 patients with ovarianendometriosisand 28 withovarianadenocarcinomas. 78 histological and 35 immunohistochemical assays of ovarian endometriosis were conducted. 8 adenocarcinomacaseswerestudiedimmunohistochemically. Antibodies to Ki-67, Всl-2, р53 and hepatocyte nuclear factor-1beta (HNF- 1β) were used. 90 patients were prospectively analyzed with a confirmed diagnosis of ovarian endometriosis according to the pathomorphological assay. Prospective study conducted according to developed algorithm of observation and treatment of patients with risk of recurrent ovarian endometriosis. Results: in the epithelium of endometrioid cyst walls we identified foci with syncytial papillary abnormalities (39,7%), metaplasia with clear cytoplasm cells (15,4%), focal hyperplasia (3,9%). In 41% of cases, epithelial atypia was observed (6,4% – true atypia). We identified overexpression HNF-1β in foci of ovarian endometriosis regardless of the presence of atypia. This fact confirms histogenetic association with clear cell adenocarcinomas. Algorithm for monitoring and treating patients with risk of recurrent ovarian endometriosis based on a prospective study was developed. Conclusion: correctinterpretation of radiologicalmethods ofdiagnosis, histological and immunohistochemical methods (with antibodies to Ki-67, Всl-2, р53 and hepatocyte nuclear factor-1beta (HNF-1β)) and assessment of the history of each patient allows to suspect the risk of recurrence and neoplastic transformation of ovarian endometriosis and develop the right patient management tactics.