Гістероскопічні, морфофункціональні та імуногістохімічні особливості ендометрія в жінок із лейоміомою матки після різних видів органозберігаючого хірургічного лікування

In: 2309-4117 · 2015 · W7112701138
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This study evaluated endometrial morpho-functional and immunohistochemical changes after various organ-preserving surgeries for uterine leiomyoma, identifying chronic endometritis and inflammatory marker increases that necessitate postoperative dysfunction prevention.

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This study evaluated hysteroscopic, morphofunctional, and immunohistochemical changes in the endometrium of women with uterine leiomyoma following organ-preserving surgeries such as uterine artery embolization, conservative myomectomy, and hysteroscopic resection. The researchers found that these procedures often led to endometrial dysfunction, including hypoplasia, polyps, and chronic endometritis indicated by CD138 expression, alongside altered immune cell markers and increased proliferation risks. The paper explicitly states that these post-surgical alterations necessitate preventive measures to restore endometrial functional state after treatment for fibroids. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Uterus leiomyoma is the most common benign tumor that takes one of the leading places in the structure of gynecological pathology. According to different authors proportion of this disease in the infertility structure is 48–55.3%, in the structure of pregnancy miscarriage – 14–18%, in pregnancy and childbirth complications – 10–30%. Uterus leiomyoma reduces in vitro fertilization results from 29% to 9% in cases of submucous nodus localization, lowers pregnancy rate to 28.2% against 63.4% after hysteroscopic node resection.The authors performed a study to improve the efficiency of uterine fibroids treatment through the development of methods to improve the functional state of the endometrium after use of different types of organ-preserving surgery.Following data were received after various types of organ saving surgical procedures: patients with normal endometrium structure (73.33%) dominated at first group. Endometrial hypoplasia was found in 20% cases of the identified pathology. Endometrial fibro-glandular type polyps were found in 6.67% of cases. The main features of this group were uneven focal estrogen receptor down regulation, disturbance of natural killer cells CD16 and CD56 and CD45 expression, compared to the control group. Immunohistochemical study showed positive expression of CD138 (plasma) in 25% of cases in endometrium of women after uterine artery embolization, indicating the presence of chronic endometritis in this group. Immunohistochemical studies of endometrium in the third group showed high level expression of inflammatory markers (CD45, CD16 and CD56). It was detected a significant increase in expression of the proliferation marker Ki-67 in endometrial stroma in the IIIb group, indicating a potential risk of hyper proliferation against a background of inflammatory process of the endometrium.Thus, endometrium changes after organ saving surgical treatment of uterine leiomyoma, such as uterine artery embolization, conservative myomectomy, hysteroscopic resection of node determines the need for the prevention of endometrial dysfunction after surgery.
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Hysteroscopic, morphofunctional and immunohistochemical endometriun features in women with uterine leiomyoma after different types of organ-preserving treatment DOI: https://doi.org/10.18370/2309-4117.2015.26.42-48Keywords: uterine leiomyoma, endometrium, uterine artery embolization, conservative myomectomy, hysteroscopic resectionAbstract Uterus leiomyoma is the most common benign tumor that takes one of the leading places in the structure of gynecological pathology. According to different authors proportion of this disease in the infertility structure is 48–55.3%, in the structure of pregnancy miscarriage – 14–18%, in pregnancy and childbirth complications – 10–30%. Uterus leiomyoma reduces in vitro fertilization results from 29% to 9% in cases of submucous nodus localization, lowers pregnancy rate to 28.2% against 63.4% after hysteroscopic node resection. The authors performed a study to improve the efficiency of uterine fibroids treatment through the development of methods to improve the functional state of the endometrium after use of different types of organ-preserving surgery. Following data were received after various types of organ saving surgical procedures: patients with normal endometrium structure (73.33%) dominated at first group. Endometrial hypoplasia was found in 20% cases of the identified pathology. Endometrial fibro-glandular type polyps were found in 6.67% of cases. The main features of this group were uneven focal estrogen receptor down regulation, disturbance of natural killer cells CD16 and CD56 and CD45 expression, compared to the control group. Immunohistochemical study showed positive expression of CD138 (plasma) in 25% of cases in endometrium of women after uterine artery embolization, indicating the presence of chronic endometritis in this group. Immunohistochemical studies of endometrium in the third group showed high level expression of inflammatory markers (CD45, CD16 and CD56). It was detected a significant increase in expression of the proliferation marker Ki-67 in endometrial stroma in the IIIb group, indicating a potential risk of hyper proliferation against a background of inflammatory process of the endometrium. Thus, endometrium changes after organ saving surgical treatment of uterine leiomyoma, such as uterine artery embolization, conservative myomectomy, hysteroscopic resection of node determines the need for the prevention of endometrial dysfunction after surgery. References - Grishin, I.I. Uterine artery embolization. New technologies in operative gynecology and obstetrics. In the manuscript rights. 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