Treatment of Chronic Endometritis with Vague Symptoms in Patients with Endometrial Hyperplasia

Aim. To develop new therapeutic approaches for chronic endometritis with vague symptoms, which is frequently diagnosed in patients with endometrial hyperplasia. Materials and Methods. We collected the material from uterine scrapings in patients (age 25-63 years) with endometrial hyperplasia (diagnosed by ultrasound examination) and abnormal uterine bleeding which occurred during hysteroscopic dilation and curettage. Among the exclusion criteria were intraepithelial neoplasia and atypical endometrial hyperplasia, cancer, systemic inflammation, and hormonal therapy. To verify the diagnosis, we employed immunohistochemistry, digital slide scanning, and morphometry. Results. This study confirmed the value of immunohistochemical diagnosis underlying the pathogenetic therapy of endometrial hyperplasia using non-steroidal anti-inflammatory drugs. Inflammatory markers indicating the distribution and quantitative alterations in cell populations had the highest diagnostic value. Conclusion. We developed a molecularly oriented algorithm for the treatment of patients with endometrial hyperplasia. This algorithm improves existing preventive, diagnostic and therapeutic approaches using immunohistochemical techniques. Such molecular testing can help in making correct therapeutic decisions.