Влияние мелатонина на активность районов ядрышковых организаторов у женщин с эндометриозом яичников

Abstract

Aim. To study the activity of ribosomal synthesis in women with ovarian endometriosis and its relationship with melatonin levels. Materials and methods. The study included 52 women with ovarian endometriosis. All patients were admitted to the gynecological department of the Clinic of the Southern State Medical University of the Russian Federation for surgical treatment. The paper uses the classification of ovarian endometriosis L. V. Adamyan (1998). During the study, 3 groups were formed: 1 group-stage 1 (n = 8), 2 group – stage 2 (n = 29), 3 group- stage 3 (n = 15).There were no patients with stage 4 ovarian endometriosis. Anamnesis was collected in all women, therapeutic and diagnostic laparoscopy, 6-SOMT was determined in the morning portion of urine, the activity of nucleolar organizer areas in the tissue of endometrioid foci of the ovaries was determined. Statistical data processing was performed using the IBM SPSS Statistics 19 software package. Results. In women with ovarian endometriosis, the lowest level of melatonin in the urine is observed at 1 and 3 stages. In patients with 1 stage ovarian endometriosis, its level was 41.14 ± 1.80 ng / ml; in group 2 – 71.16 ± 2.19 ng/ml, in group 3 – 54.01 ± 1.33 ng / ml (p = 0.048, p1-2 < 0.001, p2-3 = 0.046, p1-3 = 0.062). The main complaint in patients with stage 1 endometriosis was infertility – 8 (100%). The level of melatonin in the urine was significantly reduced in all groups of patients with ovarian endometriosis and infertility, independently of the stage. In patients with 1 stage ovarian endometriosis with low melatonin levels, proliferative diseases of the uterus (uterine fibroids, endometrial polyps, endometrial hyperplasia) are more common in the anamnesis. The number of intranuclear and extranuclear argentaffin inclusions, as well as their combination (INC + ENC) was significantly higher in stage 3 of ovarian endometriosis than in 1 and 2 stages. In endometriosis of the ovaries, a decrease in the level of melatonin in the urine correlates with an increase in the number of cells with a high degree of ribosomal synthesis activity. Conclusion. In women with endometriosis, the lowest values of melatonin were found at stage 1, especially in the presence of infertility, as well as in the common process. The activity of nucleolar organizers, which characterizes the intensity of ribosomal synthesis and the severity of proliferation, was significantly increased in the epithelial cells of ovarian endometriomas at stage 3, while an inverse relationship was revealed between the level of melatonin and the activity of nucleolar organizers.