CLINICAL ASPECTS OF PRESERVING HEALTH OF WOMEN WITH HYPERPROLIFERATIVE PATHOLOGY OF THE ENDOMETRY

The problem of hyperplastic processes of the endometrium (HPE) in women of reproductive age causes increased attention of clinicians, since it is a potential cause of decreased fertility and the risk of developing cancer, has been steadily growing in recent years in most countries of the world, including in our country. The aim: improving the quality of diagnosis, treatment and objectification of the prognosis of recurrent endometrial hyperplasia based on the determination of markers of apoptosis, proliferation, receptor and oxidative status in women of reproductive age. Materials and methods: The study was carried out on the basis of the gynecological department of the Sumy Regional Clinical Perinatal Center during 2017-2020. We examined 96 patients of reproductive age with a morphologically confirmed diagnosis of endometrial hyperplasia in the absence of hormonal therapy during the last 3 months. The control group consisted of 36 patients without endometrial pathology. Hysteroscopy was performed from the 6th to the 11th day of the menstrual cycle. The surgical material was subjected to morphological examination. Histological and immunohistochemical examination of endometrial tissue was performed according to the generally accepted method on the basis of the Department of Pathomorphology of Sumy State University. Results and discussion: Recurrent forms endometrial hyperplasia without atypia develop due to an increase in the expression of estrogen and progesterone receptors in simple and complex forms of pathology, which is accompanied by the most pronounced changes in lipid peroxidation processes (an increase in the content of lipid peroxidation products (in 2.4 and 2.8 times the level of diene conjugates, 1.3 and 2.2 times the content of malondialdehyde, p<0.05) and a decrease in the power of antioxidant protection (a decrease in catalase activity by 1.2 times, superoxide dismutase by 1.3 times, p <0.05) in women with endometrial hyperplasia, respectively, compared with practically healthy women. Conclusions: The developed set of measures optimizes the treatment of patients, provides full formation of the normal structure of the endometrium, optimization of the menstrual cycle, which reduces the recurrence of endometrial hyperplasia by 32.5%, improves fertility and reproductive function by 42.9%.