scholarly journals Hyperplastic processes in the endometrium of postmenopausal women

2021 ◽  
pp. 48-54
Author(s):  
Yu. A. Lyzikova ◽  
A. N. Lyzikov
Keyword(s):  
Postmenopausal Women ◽  
Endometrial Hyperplasia ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Area Under The Curve ◽  
Endometrial Biopsy ◽  
Retrospective Case ◽  
Normal Endometrium ◽  
Ultrasound Study ◽  
Endometrial Pathology

Objective: to specify indications for endometrial biopsy in postmenopausal women with endometrial pathology revealed by ultrasound, to study the structure of comorbidity, the parity of pregnancies and childbirth in patients with endometrial hyperplasia.Material and methods. We performed an observational retrospective case-control study. The study included 60 postmenopausal patients with endometrial pathology revealed by ultrasound referred for further endometrial biopsy. After the results of the histological examination of the endometrium had been obtained, 30 patients who had detected endometrial pathology were included in the study group, 30 patients with histologically normal endometrium were included in the comparison group.Results. In comparing clinical and anamnestic data, no statistically significant differences have been found between the groups. The comparison of the indices of the ultrasound study of the uterus has revealed a statistically significant M-echo value in patients with confirmed endometrial pathology — 10.00 (8.00; 13.00) mm, in the comparison group — 7.80 (6.00; 9.75) mm. If an M-echo value is > 7 mm with a sensitivity of 76.67 % and a specificity of 46.65%, endometrial pathology is likely to develop. The area under the curve (AUC) was 0.706 (95 % CI 0.574 — 0.816; p < 0.001).Conclusion. The obtained data determine an M-echo value more than 7 mm detected by ultrasound as an indication for endometrial biopsy in postmenopausal patients. If an M-echo value is from 5 to 7 mm and clinical manifestations are absent, dynamic observation with ultrasound control can be performed. No specific risk factors for the disease have been found in the postmenopausal patients with endometrial hyperplasia, which necessitates the search for the genetic markers of estrogen metabolic disorders.

scholarly journals The role of steroid receptors in the pathogenesis of adenomyosis in the presence of concomitant endometrial pathology in postmenopause

2019 ◽  
Vol 25 (1) ◽  
pp. 45-54
Author(s):  
G.Yu. Honcharenko
Keyword(s):  
Postmenopausal Women ◽  
Comparison Group ◽  
Steroid Receptors ◽  
Eutopic Endometrium ◽  
Immunohistochemical Reaction ◽  
Age Related ◽  
Endometrial Pathology ◽  
Er Expression ◽  
Age Related Changes

Determining the pathogenesis of adenomyosis in postmenopausal women is promising, as it will allow a more thorough study of the mechanisms of hormonal changes and resolve issues related to adenomyosis in women of reproductive age. The purpose of the study is to establish the role of steroid receptors in the pathogenesis of adenomyosis in the presence of concomitant endometrial pathology in postmenopausal women. Study material is removed uteri with parovaria from 117 patients of 49-76 years old. The cases were divided into 4 groups depending on the presence of adenomyosis (AM) and background pathology (endometrioid carcinoma of the endometrium (ECE) and endometrial hyperplasia (EHP)): 1) 27 women with adenomyosis and EHP; 2) 30 women with adenomyosis and ECE; 3) 30 women with adenomyosis and age-related changes in the endometrium; 4) 30 women with age-related changes without AM (comparison group). The immunohistochemical reaction was carried out using primary antibodies to estrogen (ER), progesterone (PR) and androgen (AR) receptors. Statistical processing was carried out using parametric methods of variation statistics (calculated the arithmetic mean, standard deviation, confidence interval, Student criterion). The predominance of the ER expression in the glandular and stromal components of the eutopic endometrium in the presence of AM and hyperplastic processes was compared with the comparison group (p<0.01). A high level of ER expression is characteristic of the epithelium of the endometrium with EHP (7.333±0.314) and ECE (6.200±0.712) rather than for the endometrium with atrophic changes in the presence of AM (4.433±0.773). In the stroma, a high ER activity was detected with EHP (7.148±0.276) rather than with atrophic changes (4.567±0.738) and ECE (4.167±0.602). It was established that in the epithelium of adenomyosis foci, ER expression indices were lower in atrophy (3.433±1.074) than with AM foci in ECE (4.667±0.526) and EHP (5.148±0.745). In the stroma of adenomyosis foci, ER expression is higher in EHP than in ECE and atrophy. The activity of PR in the eutopic endometrium decreases from simple non-typical to complex atypical EHP and in patients with adenomyosis and ECE, as the degree of differentiation of cells of ECA decreases (from G1 to G3 ECE). A minimal expression of PR was found in the comparison group. In the cells of internal endometriosis there were positive indices of immunohistochemical reaction with PR. There were obtained minimum scores for receptor expression of AR in eu- and ectopic endometria. Conclusion: adenomyosis foci have a regulatory effect on the uterine endometrium, stimulating the expression of ER and, to a lesser extent, PR, and do not affect the level of AR in the eutopic endometrium.

scholarly journals Accuracy of Preoperative Endometrial Sampling for the Detection of Endometrial Pathology: a Retrospective Study

2017 ◽  
pp. 23
Author(s):  
Keven P M Tali ◽  
Lilli M T Cole
Keyword(s):  
Endometrial Hyperplasia ◽  
Frozen Section ◽  
Medical Center ◽  
Abnormal Uterine Bleeding ◽  
Study Data ◽  
Endometrial Biopsy ◽  
Predictive Values ◽  
Endometrial Sampling ◽  
Test Result ◽  
Endometrial Pathology

Objective: To investigate the accuracy of endometrial sampling in the diagnosis of endometrial pathology and the need of intraoperative frozen section. Methods: One hundred forty women who underwent endometrial sampling followed by hysterectomy between 2011 and 2014 were included in this study. Data were retrieved from patient files and pathology archives in Department of Obstetrics and Gynecology, Jose R. Reyes Memorial Medical Center, Manila, Philippines. Results: There were 25 patients with malignancy but endometrial sampling detected only 22 of them. The endometrial sampling sensitivity and specificity for detecting cancer were 88% and 100%, respectively with negative and positive predictive values of 97.5% and 100%, respectively. In 3 patients, the endometrial sampling failed to detect malignancy; 1 patient had a preoperative diagnosis of complex hyperplasia with atypia, 1 patient had complex hyperplasia without atypia and 1 patient had adenofibroma. A total of eighty patients had benign findings. There were fifty-three cases with finding of proliferative endometrium and twenty-seven were secretory. Twenty-three (55.0%) and 11 (39.0%) cases were confirmed by the hysterectomy specimen, respectively. The sensitivity of endometrial sampling in detecting benign samples was 76.0% and the specificity reached up to 83.0%. The histopathology result of the other fourteen cases were reported of having atrophy, twelve cases were reported of having endometrial hyperplasia, four with basal endometrium, four with endometrial polyp and one with adenomyosis. Conclusion: Outpatient endometrial biopsy has a high overall accuracy in diagnosing endometrial cancer when the specimen obtained is sufficient. A positive test result is more accurate for ruling in disease than a negative test result is for ruling it out. However, the diagnosis should be confirmed by frozen section in patients with complex hyperplasia and adenofibroma. [Indones J Obstet Gynecol 2017; 5-1: 23-29] Keywords: abnormal uterine bleeding, endometrial hyperplasia, endometrial sampling, frozen section, pipelle

scholarly journals Endometrial biopsy is an important diagnostic tool for the evaluation of abnormal uterine bleeding

2021 ◽  
Vol 4 (1) ◽  
pp. 19-22
Author(s):  
Jaafar Makki ◽  
Ali hussein Al Khafaj
Keyword(s):  
Vaginal Bleeding ◽  
Endometrial Hyperplasia ◽  
Hydatidiform Mole ◽  
Endometrial Biopsy ◽  
Endometrial Polyp ◽  
Uterine Perforation ◽  
Organic Disease ◽  
Normal Endometrium ◽  
Chronic Endometritis ◽  
Abnormal Vaginal Bleeding

In this study 100 biopsies were taken from the endometrium of childbearing women (18-50 yrs. of age) suffering from abnormal vaginal bleeding from Jan 2019-Dec 2019. Endometrial Biopsy (EB) is safe, an outpatient procedure, low cost, carries out without general anesthesia & the incidence of hemorrhage, infection & uterine perforation are less common than with D&C. EB is an alternative to dilatation & curette (D&C) for the evaluation of infertile & abnormal vaginal bleeding or dysmenorrheic patients. There are two main groups of causes to irregular vaginal bleeding. 1. Organic disease (74% of the cases), in this group there are obvious lesion such as, endometrial polyp, endometrial hyperplasia & chronic endometritis. The most common cause was endometrial hyperplasia 48%, it is commonly seen during the perimenopausal period (40-50yr). Less common causes include chronic endometritis 8%, hydatidiform mole 7%, and endometrial polyp 7%. 2. non-organic disease comprises 19% of all cases, anovulatory period 13% or Luteal phase insufficiency 6%. They are commonly seen from age of 18-40yrs. 6% of the cases found to have normal endometrium. 5 endometrial biopsies were inadequate & unsatisfactory for histopathological interpretation. The aim of this study is to evaluate the usefulness & disadvantages of EB & to compare it with the traditional method of endometrial curette.

scholarly journals Determining a threshold measurement of Endometrial Thickness for Asymptomatic Postmenopausal Women: A single-centre case series

2021 ◽  
Author(s):  
Amy Stewart ◽  
Gurjot Gill ◽  
Emma Readman ◽  
Sonia Grover ◽  
Samantha Mooney
Keyword(s):  
Postmenopausal Women ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Case Series ◽  
Retrospective Case ◽  
Endometrial Sampling ◽  
Pathology Classification ◽  
Menopausal Women ◽  
The Mean ◽  
Post Menopausal

Objective: To determine the endometrial thickness at which endometrial sampling is indicated in asymptomatic post-menopausal women referred with thickened endometrium on ultrasound. Design: Retrospective case series Setting: Mercy Hospital for Women, Melbourne Population: Post-menopausal women without bleeding, undergoing hysteroscopy for thickened endometrium Methods: Logistic regression was used to examine the association between a range of variables and pre-malignant or malignant pathology and endometrial thickness Main outcome measures: The primary outcome was endometrial malignancy/pre-malignancy and its relation to endometrial thickness. Secondary outcomes focused on identifying additional predictors which may influence endometrial malignancy such as ultrasound findings, years since menopause, age, obesity, diabetes, and tamoxifen use. Results: A total of 404 postmenopausal women met the inclusion criteria for this study. The mean (SD) age of patients at presentation was 65 (9.09) years and the mean BMI was 29.86 kg/m2 (6.52). Of these women, nine (2.2%) were diagnosed with endometrial carcinoma and 7 (1.7%) had endometrial hyperplasia with atypia. The most common histopathological finding was of a benign endometrial polyp (153, 37.9%). When including hyperplasia with or without atypia in histopathology of interest, a cut-off of ≥9mm provides the greatest sensitivity (83.3%) and specificity (63.8%) for a diagnosis of pre-malignant or malignant pathology (classification accuracy of 64.8%; AUROC: 0.7358, 95%CI: 0.6439, 0.8278) in this cohort. Conclusions: Using an endometrial thickness of ≥9mm can be safely used as a cut-off for endometrial sampling in post-menopausal women without bleeding. Funding: Norman Beischer Medical Research Foundation, 2018 NBMRF Grant Keywords: Endometrial thickness, Post-menopausal, endometrial hyperplasia

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.

Optimization of diagnostic system of hand diseases in employees working under combined effects of vibration and physical overloads

2019 ◽  
pp. 950-955
Author(s):  
M. M. Poroshina ◽  
E. M. Vlasova ◽  
A. Ya. Perevalov
Keyword(s):  
Working Conditions ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Diagnostic System ◽  
Pain Syndrome ◽  
Observation Group ◽  
Combined Effects ◽  
X Rays ◽  
Industrial Enterprises ◽  
Special Assessment

The results of research carried out by theFederalScientificCenterfor Medical and Preventive Technologies of Public Health Risk Management Technologies for the period 2013–2018 showed that diseases associated with the combined effects of vibration and physical overload, employees of hazardous industries develop with experience of 15 years or more. The risk group is women older than 35 years and men older than 40 years. Pathology at the stage of detailed clinical manifestations is characterized by persistent pain syndrome, and, as a consequence, a decrease in the ability to work of workers.The aim of the study was to optimize the system of diagnosis of hand diseases in workers of industrial enterprises engaged in labor activities under the combined effects of vibration and physical overload, for the development of primary prevention programs.The observation group consisted of 32 employees aged 39.3±4.3 years, with an experience of 17.4±4.3 years; the comparison group consisted of 30 employees whose working conditions are not related to the studied factors; the average age was 40.6±3.4 years, experience was 19.1±3.1 years. The examination included analysis of the results of a special assessment of working conditions; assessment of neurological status; functional tests; laboratory studies (assessment of inflammation), hand dynamometry, stimulation electroneuromyography; x-rays of the hands and wrist joints, ultrasound examination of the hands.More than half of the surveyed persons of the observation group and 3/4 of the workers of the comparison group did not make complaints. Indicators of dynamometry of workers in both groups corresponded to physiological norm (p>0.05). Analysis of the results of dynamometer with data from previous years of PMO showed a decrease in strength of muscles of the hand leading hands on 2je,0–16. 7% and from 83.3% of the employees of the monitoring group and in 44.4% of the comparison group (p<0.05), in 50 % of the cases there was a decrease in the percentage of changes in the hand force variation (HFV) in the observation group, and in 38.9% of the cases the indicators remained unchanged. According to ultrasound of the hands, signs of tendinopathy were established in 85% of the employees of the observation group in the absence of persons with similar changes in the comparison group.In order to optimize the diagnosis of diseases of the hand in industrial workers who carry out their work under the combined effects of vibration and physical overload, in the case of a decrease in the rate of carpal dynamometry by 5% or more during the year, it is recommended to conduct ultrasound of the tendon-ligamentous apparatus of the hand, which will allow timely identification of early signs of tendinopathy.

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.

Alterations of serum levels of plasminogen, TNF-α, and IDO in granulomatosis with polyangiitis patients

Vascular ◽  
2021 ◽  
pp. 170853812098630
Author(s):  
Dobroslav Kyurkchiev ◽  
Tsvetelina Yoneva ◽  
Adelina Yordanova ◽  
Ekaterina Kurteva ◽  
Georgi Vasilev ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Necrosis Factor Alpha ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Tnf Α ◽  
Spearman’S Rho

Background Granulomatosis with polyangiitis (GPA) is a representative of vasculitides associated with anti-neutrophil cytoplasmic autoantibodies. “Classical” antibodies directed against proteinase 3 are involved in the pathogenesis and are part of the GPA diagnosis at the same time. Along with them, however, antibodies against Lysosomal-Associated Membrane Protein-2 (LAMP-2) and antibodies directed against plasminogen have been described in GPA. Objectives and methodology: We performed a cross-sectional study enrolling 34 patients diagnosed with GPA. Our study was aimed at looking for correlations between serum levels of LAMP-2 and plasminogen and the clinical manifestations of the GPA. Furthermore, we examined serum levels of tumor necrosis factor-alpha (TNF-α) and its associated indoleamine-pyrrole 2,3-dioxygenase (IDO), as well as we looked for a correlation between these cytokines and the clinical manifestations of GPA. Results The results showed that in GPA, serum plasminogen levels were negatively associated with renal involvement (receiver operating characteristic (ROC) area under the curve (AUC) of 0.78) (95% CI 0.53–0.91), p = 0.035, and the extent of proteinuria, Spearman’s Rho = –0.4, p = 0.015. Increased levels of TNF-α and IDO correlated with disease activity, Spearman’s Rho =0.62, p = 0.001 and Spearman’s Rho = 0.4, p = 0.022, respectively, whereas only TNF-α was increased in severe forms of GPA with lung involvement (ROC AUC of 0.8) (95% CI 0.66–0.94), p = 0.005. Conclusions In this study, we demonstrate the alteration of soluble factors, which play an important role in the pathogenesis of GPA and their relationship with the clinical manifestations of the disease. Our main results confirm the associations of increased secretory TNF-α and some clinical manifestations, and we describe for the first time decreased serum plasminogen levels and their association with renal involvement.

scholarly journals A novel combination of serum microRNAs for the detection of early gastric cancer

2021 ◽  
Author(s):  
Seiichiro Abe ◽  
Juntaro Matsuzaki ◽  
Kazuki Sudo ◽  
Ichiro Oda ◽  
Hitoshi Katai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Expression Profiles ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Cancer Center ◽  
Serum Samples ◽  
Retrospective Case ◽  
Serum Mirnas ◽  
Validation Set

Abstract Background The aim of this study was to identify serum miRNAs that discriminate early gastric cancer (EGC) samples from non-cancer controls using a large cohort. Methods This retrospective case–control study included 1417 serum samples from patients with EGC (seen at the National Cancer Center Hospital in Tokyo between 2008 and 2012) and 1417 age- and gender-matched non-cancer controls. The samples were randomly assigned to discovery and validation sets and the miRNA expression profiles of whole serum samples were comprehensively evaluated using a highly sensitive DNA chip (3D-Gene®) designed to detect 2565 miRNA sequences. Diagnostic models were constructed using the levels of several miRNAs in the discovery set, and the diagnostic performance of the model was evaluated in the validation set. Results The discovery set consisted of 708 samples from EGC patients and 709 samples from non-cancer controls, and the validation set consisted of 709 samples from EGC patients and 708 samples from non-cancer controls. The diagnostic EGC index was constructed using four miRNAs (miR-4257, miR-6785-5p, miR-187-5p, and miR-5739). In the discovery set, a receiver operating characteristic curve analysis of the EGC index revealed that the area under the curve (AUC) was 0.996 with a sensitivity of 0.983 and a specificity of 0.977. In the validation set, the AUC for the EGC index was 0.998 with a sensitivity of 0.996 and a specificity of 0.953. Conclusions A novel combination of four serum miRNAs could be a useful non-invasive diagnostic biomarker to detect EGC with high accuracy. A multicenter prospective study is ongoing to confirm the present observations.

scholarly journals Endometritis in the bitch: Immunohistochemical localization of cyclooxygenase 2

2020 ◽  
Vol 10 (2) ◽  
pp. 157-163
Author(s):  
María Carla García Mitacek ◽  
Romina Gisele Praderio ◽  
María Cecilia Stornelli ◽  
Rodolfo Luzbel De la Sota ◽  
María Alejandra Stornelli
Keyword(s):  
Stromal Cells ◽  
Endometrial Hyperplasia ◽  
Inflammatory Cells ◽  
Immunohistochemical Localization ◽  
Cyclooxygenase 2 ◽  
Immunohistochemical Expression ◽  
Normal Endometrium ◽  
Pathophysiological Mechanisms ◽  
Mixed Breed ◽  
Strong Staining

Background: In several mammals, subfertility or infertility associated with endometritis was reported. Although there have been studies about endometritis in bitches, the pathophysiological mechanisms are not completely known.Aim: This study aimed to evaluate the immunohistochemical expression of Cyclooxygenase 2 (COX2) in clinically healthy bitches with normal uterine tissue and bitches with endometritis.Methods: Forty-eight mixed breed bitches in diestrus were used. Uterine biopsies were collected for diagnosis [normal endometrium (n = 15; NE), cystic endometrial hyperplasia (n = 1), atrophy (n= 2), acute endometritis (n = 9; AE), subacute endometritis (n = 7; SE), and chronic endometritis (n = 14; CE)]. Immunostaining and quantification of positively stained cells was performed on full-thickness uterine biopsies. Data were analyzed by the GLIMMIX procedure of SAS.Results: COX2 immunostaining was scattered and restricted to cells in the stroma in bitches with NE. However, in bitches with endometritis, strong staining was observed in the luminal epithelium, glandular epithelium, and stromal cells. Staining was also observed in inflammatory cells localized in the stroma as well as inside of the glands. The percentage of COX2 positive stromal cells in bitches with AE, SE, and CE was significantly higher compared with NE (p < 0.005). In addition, the percentage of COX2 positive stromal cells in bitches with SE, and CE was significantly lower compared with AE (p < 0.003).Conclusion: COX2 could be involved in the pathophysiological mechanisms producing endometritis without the presence of cystic endometrial hyperplasia in bitches. However, further researches on this topic are required. Keywords: Bitch, COX2, Endometritis, Immunohistochemical.

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