scholarly journals Modern aspects of the etiology and pathogenesis of hyperplastic endometrial processes

2021 ◽  
Vol 4 ◽  
pp. 7-18
Author(s):  
V.O. Benyuk ◽  
V.M. Goncharenko ◽  
Yu.V. Kravchenko ◽  
O.V. Kalenska ◽  
Niki Abedi Astaneg
Keyword(s):  
Endometrial Hyperplasia ◽  
Reproductive Potential ◽  
Uterine Bleeding ◽  
High Recurrence Rate ◽  
Antiapoptotic Protein ◽  
Protein P53 ◽  
Proapoptotic Protein ◽  
Proliferation And Apoptosis ◽  
Apud System ◽  
New Criteria

The article presents modern approaches to the etiology, classification and pathogenesis of endometrial hyperplastic processes. Hyperplastic processes of the endometrium, representing an urgent medical and social problem, which is due to the peculiarities of the clinical manifestation of the disease (uterine bleeding), reduced reproductive potential, high recurrence rate, limited conservative treatment of this pathology in pre- and postmenopausal women, due to concomitant extragenital diseases and a high risk of malignancy.On the basis of new criteria of pathomorphological diagnostics, drawing parallels with the accumulated experience and clinical data, the immunohistochemical profile for each histotype of hyperplastic process of endometrium is created, certain diagnostic determinants are defined. Namely, simple and complex endometrial hyperplasia without atypia are characterized by imbalance between proliferation and apoptosis, manifested in moderate activation of the intratissue APUD system, lack of activation of proapoptotic protein p53, increased levels of antiapoptotic protein 2. Atypical forms of endometrial hyperplasia (simple and complex) are characterized by expression in the epithelial component of the proapoptotic protein p53, an increase in the level of antiapoptotic protein Bcl-2 in 2-2.5 times, expressed by activation of the intratissue APUD system.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

scholarly journals Prediction of Endometrial Hyperplasia and Cancer among Premenopausal Women with Abnormal Uterine Bleeding

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Luca Giannella ◽  
Lillo Bruno Cerami ◽  
Tiziano Setti ◽  
Ezio Bergamini ◽  
Fausto Boselli
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Prediction Model ◽  
Endometrial Hyperplasia ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Stepwise Logistic Regression ◽  
Simultaneous Presence ◽  
Endometrial Pathology

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.

scholarly journals Early Lipid Raft-Related Changes: Interplay between Unilateral Denervation and Hindlimb Suspension

2021 ◽  
Vol 22 (5) ◽  
pp. 2239
Author(s):  
Irina G. Bryndina ◽  
Maria N. Shalagina ◽  
Vladimir A. Protopopov ◽  
Alexey V. Sekunov ◽  
Andrey L. Zefirov ◽  
...  
Keyword(s):  
Lipid Raft ◽  
Hindlimb Suspension ◽  
Short Term ◽  
Antiapoptotic Protein ◽  
Muscle Disuse ◽  
Proapoptotic Protein ◽  
Raft Fraction ◽  
Rat Soleus Muscle ◽  
Afferent Inputs ◽  
Underlying Mechanisms

Muscle disuse and denervation leads to muscle atrophy, but underlying mechanisms can be different. Previously, we have found ceramide (Cer) accumulation and lipid raft disruption after acute hindlimb suspension (HS), a model of muscle disuse. Herein, using biochemical and fluorescent approaches the influence of unilateral denervation itself and in combination with short-term HS on membrane-related parameters of rat soleus muscle was studied. Denervation increased immunoexpression of sphingomyelinase and Cer in plasmalemmal regions, but decreased Cer content in the raft fraction and enhanced lipid raft integrity. Preliminary denervation suppressed (1) HS-induced Cer accumulation in plasmalemmal regions, shown for both nonraft and raft-fractions; (2) HS-mediated decrease in lipid raft integrity. Similar to denervation, inhibition of the sciatic nerve afferents with capsaicin itself increased Cer plasmalemmal immunoexpression, but attenuated the membrane-related effects of HS. Finally, both denervation and capsaicin treatment increased immunoexpression of proapoptotic protein Bax and inhibited HS-driven increase in antiapoptotic protein Bcl-2. Thus, denervation can increase lipid raft formation and attenuate HS-induced alterations probably due to decrease of Cer levels in the raft fraction. The effects of denervation could be at least partially caused by the loss of afferentation. The study points to the importance of motor and afferent inputs in control of Cer distribution and thereby stability of lipid rafts in the junctional and extrajunctional membranes of the muscle.

scholarly journals The Gene That Encodes the Herpes Simplex Virus Type 1 Latency-Associated Transcript Influences the Accumulation of Transcripts (Bcl-xL and Bcl-xS) That Encode Apoptotic Regulatory Proteins

2003 ◽  
Vol 77 (19) ◽  
pp. 10714-10718 ◽  
Author(s):  
Weiping Peng ◽  
Gail Henderson ◽  
Guey-Chuen Perng ◽  
Anthony B. Nesburn ◽  
Steven L. Wechsler ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Virus Type ◽  
Herpes Simplex Virus Type ◽  
Regulatory Proteins ◽  
Antiapoptotic Protein ◽  
Proapoptotic Protein ◽  
Simplex Virus

ABSTRACT The herpes simplex virus type 1 latency-associated transcript (LAT) inhibits apoptosis. We demonstrate here that LAT influences the accumulation of the Bcl-xL transcript versus the Bcl-xS transcript in Neuro-2A cells. Bcl-xL encodes an antiapoptotic protein, whereas Bcl-xS encodes a proapoptotic protein. Promoting the accumulation of Bcl-xL in neurons may inhibit apoptosis, thus enhancing the latency-reactivation cycle.

scholarly journals Hysteroscopic evaluation in infertility and abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 612
Author(s):  
Navneet Kaur ◽  
Ruby Bhatia ◽  
Paramjit Kaur ◽  
Surinder K. Bhopal
Keyword(s):  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Therapeutic Modality ◽  
Secondary Infertility ◽  
Endometrial Polyps ◽  
Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

Pathogenetic mechanisms of endometrial hyperplasia in women of reproductive age

2020 ◽  
Vol 19 (5) ◽  
pp. 44-50
Author(s):  
I.M. Ordiyants ◽  
◽  
A.A. Kuular ◽  
A.A. Yamurzina ◽  
D.S. Novginov ◽  
...  
Keyword(s):  
Estrogen Receptors ◽  
Pyruvate Kinase ◽  
Endometrial Hyperplasia ◽  
Uterine Fibroids ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Pyruvate Kinase M2 ◽  
Pathogenetic Mechanisms ◽  
Group I

Objective. To analyze pathogenetic mechanisms underlying the development of endometrial hyperplasia in women of reproductive age. Patients and methods. We have examined 143 women of reproductive age with endometrial hyperplasia (EH). Study participants were divided into three groups: Group I included EH patients without atypia; Group II included patients with atypical hyperplasia of the endometrium; Group III (control group) comprised 56 women with abnormal uterine bleeding, in whom we excluded adenomyosis, uterine fibroids, endometrial hyperplasia, endometrial cancer, and iatrogenic causes of uterine bleeding. Genomic DNA was isolated using phenol-chloroform extraction. Real-time polymerase chain reaction (RT-PCR) was used to detect microRNA-210, -18a, -221, and -222. The detection of tumor pyruvate kinase M2 was performed using the ScheBo® Tumor M2-PK kit designed for quantitative assessment of this metabolic cancer marker in plasma and endometrial tissue samples. Results. Significant risk factors triggering the pathogenetic mechanism of EH development in reproductive age include extragenital disorders (obesity, thyroid diseases, diseases of the urinary system, hypertension) and gynecological diseases (pelvic inflammatory diseases, adenomyosis, benign breast dysplasia, uterine fibroids). Alterations affecting estrogen receptors lead to changes in microRNA messengers, which, in turn, affect target genes and cause changes in the adaptive abilities of the cell. Expression of pyruvate kinase M2 in this chain confirms proapoptotic changes in the cell and the risk of its atypia. Conclusion. The pathogenesis of EH is based on the following factors: polymorphism of the ERS1 and PRG genes, increased expression of miRNA-210, -18a, and -222, decreased expression of miRNA-221, and overexpression of pyruvate kinase M2. Key words: endometrial hyperplasia, miRNA, pyruvate kinase M2, progesterone receptors, estrogen receptors

scholarly journals Role of hysteroscopy and histopathology in evaluating patients with abnormal uterine bleeding

2017 ◽  
Vol 6 (2) ◽  
pp. 615 ◽  
Author(s):  
Nighat Firdous ◽  
Samar Mukhtar ◽  
Sheikh Bilal ◽  
Salma Kounsar Beigh
Keyword(s):  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Endometrial Polyps ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Definitive Role

Background: Abnormal uterine bleeding is one of the leading causes for seeking gynaecological advice. The aim and objectives of the study was to determine the pattern of hysteroscopic abnormalities and histopathological features of Abnormal Uterine Bleeding and to correlate hysteroscopic findings with histopathological findings.Methods: The present study “Role of Hysteroscopy and Histopathology in Evaluating patients with Abnormal Uterine Bleeding” was an observational study carried out in the Postgraduate Department of Obstetrics and Gynaecology and Postgraduate Department of Pathology of Government Medical college, Srinagar after obtaining clearance from the institutional ethical committee. The period of the study was One and a Half Years from April 2014 to September 2015.Results: The most common abnormality detected by hysteroscopy was Endometrial Hyperplasia (27 cases, 27%) followed by endometrial polyps (21 cases, 21%). Endometrial Hyperplasia was the most common abnormality found in Menorrhagia followed by polyps while polyps were the most common finding in polymenorrhea and endometrial hyperplasia was the most common pathology in postmenopausal bleeding. Hysteroscopy had a sensitivity of 93.2%, specificity of 83.9%, positive predictive value of 82%, Negative Predictive Value of 94% in diagnosing etiology of abnormal uterine bleeding.Conclusions: This study confirms that hysteroscopy has a definitive role in evaluating patients with abnormal uterine bleeding and hysteroscopy and histopathology complement each other in the evaluation of a patient with Abnormal uterine bleeding.

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