scholarly journals Combined Use of a-GnRH and Intrauterine Levonorgestrel Releasing System in Treatment of Atypical Endometrial Hyperplasia in Women of Reproductive Age

Doctor Ru ◽  
2020 ◽  
Vol 19 (1) ◽  
pp. 51-54
Author(s):  
A.I. Pashov ◽  
◽  
E.N. Sivova ◽  
Ya.Yu. Metrinskiy ◽  
◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Atypical Endometrial Hyperplasia ◽  
Combined Use

MODERN OUTLOOKS ON PREVALENCE OF ESR1 AND PRG POLYMORPHISM IN WOMEN OF REPRODUCTIVE AGE WITH ENDOMETRIAL HYPERPLASIA

2020 ◽  
pp. 112-120
Author(s):  
I.M. Ordiyants ◽  
A.A. Kuular ◽  
A.A. Yamurzina ◽  
T.A. Bazieva
Keyword(s):  
Endometrial Hyperplasia ◽  
Progesterone Receptors ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Atypical Endometrial Hyperplasia ◽  
Group 3 ◽  
The Subject ◽  
Polymerase Chain ◽  
Group 2

Prevalence of proliferative processes is very high nowadays. Moreover, such processes easily transform into malignant ones. However, pathogenesis of endometrial hyperplasia (EH) is not fully understood. Imbalance of estrogen and progesterone, as well as estrogen and progesterone receptors is the reason for hyperplastic process onset in hormone-dependent tissues. Currently, there are no markers that could serve as objective predictors for EH development. It is unclear, whether EH transforms into cancer or spontaneously improves. The purpose of the study is to determine prevalence of ESR1 and PRG polymorphism in women of reproductive age with endometrial hyperplasia. Materials and Methods. Trial subjects (n=143) were divided into three groups: Group 1 consisted of 53 patients with glandular and glandular-cystic EH without atypia; Group 2 contained 34 patients with atypical EH; Group 3 was the control group. Polymerase chain reaction of DNA synthesis was used to conduct molecular and genetic loci study. Statistical analysis of the data obtained was performed with SAS JMP 11 and Statistica 10. Results. Mutant CC-allele of PvuII ESR1 polymorphism was found in every fourth woman with glandular endometrial hyperplasia and in every third patient with atypical endometrial hyperplasia. Prevalence of GG genotype of XbaI ESR1 polymorphism did not have any statistically significant differences in comparison with the control group. Mutant TT-allele of Val660Leu PRG polymorphism in glandular endometrial hyperplasia was 1.8 times more common in experimental groups than in the control one. Homozygous AA-genotype of 331G/A PRG polymorphism was not identified in women with endometrial hyperplasia. Conclusion. In endometrial hyperplasia, prevalence of mutant CC-allele of PvuII C/T ESR1 polymorphism leads to a decrease in ERa sensitivity, whereas prevalence of mutant TT-allele of Val660Leu PRG polymorphism leads to impaired sensitivity and a decrease in the biosynthesis rate of progesterone receptors. EH etiology and pathogenesis in women of reproductive age still remains the subject for future scientific research. Keywords: estrogen receptors, progesterone receptors, glandular endometrial hyperplasia, atypical endometrial hyperplasia. Актуальность проблемы пролиферативных процессов связана с высокой частотой распространения и высоким риском их трансформации в злокачественный процесс. В настоящее время до конца не изучен патогенез гиперплазии эндометрия (ГЭ). Причиной формирования гиперпластического процесса в гормонально-зависимых тканях может быть дисбаланс эстрогенов и прогестерона, а также эстрогеновых и прогестероновых рецепторов. В настоящее время отсутствуют маркеры, которые могли бы служить объективными предикторами развития ГЭ в направлении трансформации в рак или, наоборот, спонтанной ее регрессии. Цель исследования. Определить частоту встречаемости полиморфизмов генов ESR1 и PRG у пациенток репродуктивного возраста с различными вариантами гиперплазии эндометрия. Материалы и методы. Все обследованные женщины (143 чел.) были поделены на три группы: I группу составили 53 пациентки с железистой и железисто-кистозной ГЭ без атипии; II группу – 34 пациентки с атипической гиперплазией эндометрия; III группа стала контрольной. Молекулярно-генетическое исследование локусов проведено методом полимеразной цепной реакции синтеза ДНК. Статистический анализ полученных данных выполнен в программах SAS JMP 11 и Statistica 10. Результаты. Мутантный аллель СС полиморфизма PvuII гена ESR1 обнаружен у каждой четвертой женщины с железистой гиперплазией эндометрия и у каждой третей пациентки с атипической гиперплазией эндометрия. Частота встречаемости генотипа GG полиморфизма XbaI гена ESR1 в сравнении с группой контроля не имела статистически значимых различий. Мутантный аллель ТТ полиморфизма Val660Leu гена PRG при железистой гиперплазии эндометрия встречался в 1,8 раза чаще, чем в группе контроля. Гомозиготный генотип АА полиморфизма 331G/A гена PRG у женщин с гиперплазией эндометрия выявлен не был. Выводы. При гиперплазии эндометрия преобладание мутантного аллеля CC полиморфизма PvuII C/T гена ESR1 приводит к снижению чувствительности ERa, а преобладание мутантного аллеля TT полиморфизма Val660Leu гена PRG – к нарушению чувствительности и снижению скорости биосинтеза прогестероновых рецепторов. Предметом исследований по-прежнему остается концепция этиологии и патогенеза ГЭ у женщин репродуктивного возраста, что требует дальнейшего научного поиска. Ключевые слова: эстрогеновые рецепторы, прогестероновые рецепторы, железистая гиперплазия эндометрия, атипическая гиперплазия эндометрия.

Clinical and sonological features in endometriomas in women of reproductive age

2016 ◽  
pp. 85-89
Author(s):  
О. Shapoval ◽  
Keyword(s):  
Endometrial Hyperplasia ◽  
Benign Tumor ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Ovarian Endometriosis ◽  
Gynecological Examination ◽  
Different Characteristics ◽  
Ovarian Endometriomas

The objective: to study the prevalence of ovarian endometriosis in women of reproductive age, the features of clinical and ultrasound picture of endometriosis. Patients and methods. The study involved 22 patients with endometriomas, the control group – 50 women gynecological and somatically healthy. Results. The incidence of ovarian endometriomas in the structure of benign tumor-like formations of ovaries is 0.62%. In 72.73% of ovarian endometriomas occur on a background of concomitant gynecological pathology. Clinically, in 77.27% of cases there is a pain syndrome, in 59.09% – algomenorrhea, in 13.64% – infertility; 18.18% of cases endometriomas remain «dumb» and proceed with the erased clinical picture. Sonologically in patients with endometriomas adenomyosis, endometrial hyperplasia, changes in the contralateral ovary are determined. Conclusion. Without additional methods of diagnostic gynecological examination may identify the 3 cm tumor-like formation of the ovary with different characteristics, which does not allow to differentiate endometrioma from inflammation, functional and ovarian tumors. Ultrasound can diagnose pathological ovarian formation of 1 cm, detailing the nature of the cyst. Key words: endometriosis, reproductive age, retrospective analysis, ultrasound.

LIPID PEROXIDATION AND ANTIOXIDANT PROTECTION SYSTEM IN WOMEN WITH ENDOMETRIAL HYPERPLASTIC PROCESSES

2019 ◽  
pp. 44-49
Author(s):  
A.O. Atykanov ◽  
G.U. Asymbekova ◽  
A.A. Masybaeva
Keyword(s):  
Lipid Peroxidation ◽  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
Support Network ◽  
Antioxidant Protection ◽  
Women Of Reproductive Age ◽  
Atypical Form ◽  
Antioxidant Protection System ◽  
Quantitative Indicators

The paper presents quantitative indicators of lipid peroxidation (LP) products and antioxidant support network (ASN) in blood plasma in women with various histological forms of endometrial hyperplastic processes (EHPs). The goal of the paper is to assess the state of LP processes and ASN in women of reproductive age with various forms of EHPs. Materials and Methods. The trial enrolled 137 women of reproductive age: 112 women with endometrial hyperplasia (EH) and 25 women with uterine cavity synechia without EH. Conclusion. In case if EH progresses from a simple atypical form to adenocarcinoma, an increase in lipid peroxidation intensity and ASN inhibition is observed. Keywords: women, endometrial hyperplastic processes, endometrial hyperplasia, lipid peroxidation, antioxidant support network. В работе представлены количественные показатели содержания продуктов перекисного окисления липидов (ПОЛ) и системы антиоксидантной защиты (АОЗ) в плазме крови у женщин с различными гистологическими формами гиперпластического процесса эндометрия (ГПЭ). Цель исследования. Оценить состояние процессов ПОЛ и системы АОЗ при развитии различных форм ГПЭ у женщин репродуктивного возраста. Материалы и методы. Объектом исследования явились 137 женщин репродуктивного возраста: 112 женщин с гиперплазией эндометрия (ГЭ) и 25 женщин с синехиями полости матки без ГЭ. Выводы. При прогрессировании ГЭ от простой неатипичной до аденокарциномы происходит нарастание интенсивности липопереокисления и угнетения системы АОЗ. Ключевые слова: женщины, гиперпластические процессы эндометрия, гиперплазия эндометрия, перекисное окисление липидов, система антиоксидантной защиты.

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 Clinical features of polycystic ovary syndrome phenotypes in women with normogonadotropic anovulation in reproductive age

2019 ◽  
Vol 68 (3) ◽  
pp. 7-14
Author(s):  
Elena I. Abashova ◽  
Maria A. Shalina ◽  
Elena V. Misharina ◽  
Natalia N. Tkachenko ◽  
Olga L. Bulgakova
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Carbohydrate Metabolism ◽  
Clinical Features ◽  
Endometrial Hyperplasia ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Chronic Endometritis

Hypothesis/aims of study. Polycystic ovary syndrome (PCOS) is a common disease, the frequency of which ranges from 8 to 13% in women of reproductive age. PCOS is a complex polygenic endocrine disorder with reproductive, metabolic, and psychological features. Currently, four PCOS phenotypes are identified that are associated with metabolic disorders, insulin resistance, impaired glucose tolerance (IGT), diabetes mellitus, and an increase in the number of risk factors for cardiovascular diseases. The aim of this study was to investigate the clinical features of PCOS phenotypes in women with normogonadotropic anovulation in reproductive age. Study design, materials, and methods. The study included 60 women of reproductive age from 24 to 37 years (mean age 28 ± 4 years) with PCOS and normogogonadotropic, normoprolactinemic anovulation. We studied the levels of anti-mullerian, follicle-stimulating, luteinizing hormone, prolactin, estradiol, and androgens from days 2 to 5 of the menstrual cycle. The serum progesterone level was studied by ELISA using test systems manufactured by Alkor Bio Ltd. (Russia) on days 20–23 of the menstrual cycle for three consecutive cycles. The average level of progesterone in the blood on days 20–23 of the menstrual cycle was 3.1 ± 1.5 nM. Echographic methods for diagnosing polycystic ovaries were used. All women included in the study underwent hysteroscopy on days 18–22 of the menstrual cycle, followed by a histological and immunohistochemical study of the endometrium. Results. In women with anovulatory PCOS phenotypes, phenotype A (classical) was detected in 32 (53.3%) women; phenotype B (anovulatory) in 18 (30%) women; phenotype D (non-androgenic) in 10 (16.7%) women with. In 32 (53.3%) patients, changes in carbohydrate metabolism (IGT) were found. Clinical and biochemical manifestations of androgen-dependent dermopathy (acne, oily seborrhea, and hirsutism) were significantly (p < 0.05) more often observed in PCOS patients with phenotypes A (84.4%) and B (88.9%) than in women with phenotype D (30%). In the majority (93.8%) of patients with IGT, the androgenic-anovulatory PCOS phenotypes were detected: phenotype A in 20 (62.5%) women and phenotype B in 10 (31.3%) women. Phenotype D (non-androgenic) was present only in two women with PCOS and IGT. As a result of complex histological and immunohistochemical studies of endometrial biopsy specimens, chronic endometritis was detected in 44 (73.3%) examined women with PCOS and simple glandular endometrial hyperplasia was diagnosed in 13 (21.7%) PCOS patients. The incidence of chronic endometritis and simple glandular endometrial hyperplasia in women with normogonadotropic anovulation and PCOS directly depended (r = 0.35; p < 0.05) on disorders of carbohydrate metabolism and was detected more often in patients with PCOS and IGT. Conclusion. The differential approach to the examination of patients with various PCOS phenotypes allows personalizing the therapy of this disease and determining the complex of preventive measures to improve the quality of life of women of reproductive age.

Menstrual function in women with adenomiosis in combination with the hyperplastic processes of endometry on the background of hormonotherapy

2017 ◽  
pp. 115-117
Author(s):  
V.A. Benyuk ◽  
◽  
V.V. Kurochka ◽  
S.V. Benyuk ◽  
D.M. Altibaeva ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hormone Therapy ◽  
Endometrial Hyperplasia ◽  
Reproductive Age ◽  
Menstrual Blood ◽  
Menstrual Blood Loss ◽  
Women Of Reproductive Age ◽  
Menstrual Function ◽  
Complex Therapy

The objective: to study the effect of hormone therapy on menstrual function of women with adenomyosis in combination with endometrial hyperplasia. Patients and methods. We evaluated the effects of hormone therapy in 160 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: I group – 60 women used the progestogen (6 months); II – 60 women, took an agonist of gonadotropin-releasing-hormone – а-GnRH) (6 months), III – 40 women who received the complex therapy including а-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course - 6 months), then for the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25 day. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. Assessment of volume of menstrual blood loss was performed using maps of menstrual blood loss and were assessed on a special scale. The total rating for the month, which exceeded 100 points, consistent with menstrual blood loss greater than 80 ml. Results. The influence of hormonal monotherapy progestogen and а-GnRH on menstrual function of women with adenomyosis in combination with endometrial hyperplasia during the follow-up throughout the year. The assessment of indicators of volume of blood loss with the help of monitoring charts. Developed a comprehensive hormone therapy for women of reproductive age with combined benign uterus pathology and the evaluation of its impact on indicators of volume of blood loss and menstrual function of women. Conclusions. Monoterapia by the progestogen and а-GnRH for 6 months of treatment normalizes the indicators of volume of blood loss and menstrual function of women, and the 12-month follow-up in women of these groups also increased the volume of blood loss and each 3 women is marked polimenorea. Developed a comprehensive phased hormone therapy for women with adenomyosis in combination with endometrial hyperplasia normalizes on the 3rd month of treatment indicators of blood loss and has a tendency to decrease during the 12 months of observation (the volume of menstrual blood loss has decreased in 4 times from initial). Key words: complex therapy, adenomyosis, endometrial hyperplasia, gestagene, а-GnRH, menstrual function, volume of blood loss.

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