Стан мікробіоценозу ендометрія в жінок із гіперпластичними процесами та хронічним ендометритом за даними ПЛР-тесту

Abstract

Purpose - to study the status of endometrial microbiocenosis in women with hyperplasia of endometrium (HE) and to evaluate the influence of the inflammatory process in the pathogenesis of hyperplasia. Materials and methods. There were studied 161 women, of whom group 1 consisted of 58 women with HE without an inflammatory process, group 2 consisted of 71 women with a combination of HE and chronic endometritis - CE. The group 3 (control) consisted of 32 women in whom no pathological changes were found during diagnostic scraping. In all women detection of the genome of possible inflammatory process pathogens was carried out using the polymerase chain reaction (PCR). Results. According to the PCR test, the levels of staphylococcus, streptococcus, and corynebacteria were the highest in the group 3 (68.8%, 21.9%, and 50.0%, respectively), and were lower in the group 1 (46.6%, 6.9% and 24.1%, respectively), and even smaller in group 2 (31.0%, 9.9%, 12.7%, respectively). The resident microbiocenosis of the large intestine - Enterococcus faecalis - was found in the endometrium of representatives of all studied groups. Herpes virus was detected in 31.0% of women with group 1, 26.8% of women with group 2 versus 12.5% of group 3 respondents (p<0.05). Cytomegalovirus was detected in 12.1%, 11.3% vs. 3.1%, respectively (p<0.05), and papilloma virus - in 24.1% and 26.8% vs. 6.3%. The high level of associated pathogenic microflora is noteworthy, especially in the group 2, where it is 66.2%, which is significantly higher than the indicator of the group 1 (39.6%, p<0.05), and significantly higher than the group 3 indicators (9.4% p<0.001). In the group 3, tests with a low titer of enterobacteria prevail (103-104) - 97.1%, which is significantly more than in the group 1 (10.3%) and women group 2 (0%), p<0.001. In the group 1, the highest mean titer was 104-105 (89.7%), which was significantly higher than the group 2 (2.9%) and the group 3 (9.4%), p<0.001. In the group 2, the highest rate of high titer according to PCR data (>106) was 97.1%, which significantly exceeds the zero rates in both other groups. Conclusions. In the group of women with a combination of hyperplastic and inflammatory processes, we observed a significant increase in associated infectious agents, both microorganisms and viruses. One hundred percent presence of enterobacteria among female respondents of all groups is noteworthy. The detection of representatives of the intestinal microbiota in the endometrium indicates the probable role of dysbiotic disorders of the gastrointestinal tract. In our opinion, the titer of enterobacteria according to the PCR test can be a marker of the inflammatory process and a diagnostic criterion for choosing a treatment method. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.