The results of morphological studies in women of reproductive age with hyperproliferative diseases of the endometrium

Abstract

Hyperproliferative processes of the endometrium, remaining one of the most common gynecological pathologies, still have imperfections in the diagnostic stages, both invasive and non-invasive. There is still controversy about the need to differentiate between hyperplasia and endometrial polyps. And the improvement of the method of pathomorphological research and the invention of immunohistochemical markers for the endometrium, opened new opportunities for better diagnosis of hyperproliferative processes of the endometrium. Also, an important component of the diagnosis of endometrial pathology are invasive methods, namely hysteroscopy, which has eliminated most of the shortcomings associated with the classic scraping of the uterine cavity. The definition of markers of chronic endometritis has opened new questions about the origin of chronic inflammation in the uterine cavity, its course and the relationship with the biocenosis of the lower genital tract. The aim of this study was to determine the role of pathomorphological immunohistochemical cytological methods of examination and microscopy in patients of reproductive age with hyperproliferative processes of the endometrium. In order to achieve this goal, we analyzed 161 women, of whom 58 women had verified diagnoses of endometrial hyperproliferative processes, 71 women were morphologically verified diagnoses of hyperproliferative processes in combination with chronic endometritis. The control group consisted of 32 women without evidence of hyperproliferative processes of the endometrium and chronic endometritis. The age of women ranged from 18 to 53 years. Also, all women underwent cytological examination of the cervix and microscopy of vaginal swabs. According to the data obtained, the percentage ratio between the number of diagnosed endometrial polyps and endometrial hyperplasia was equal, with a slight advantage towards endometrial polyps. Other gynecological diseases such as uterine fibroids, external endometriosis and cervical polyps accounted for a total of 0.8 to 3.9 %. Cytological examination of the cervix indicated the predominance of type 2 cytology in the group of women with chronic endometritis. Analysis of microscopic data of vaginal secretions indicates an increased level of inflammation in the group of women with a combination of hyperplastic processes of the endometrium and chronic endometritis. In conclusion, it is possible to claim a slightly higher level of chronic endometritis in the group of women with endometrial polyps, compared with endometrial hyperplasia. There is also a clear link between the diagnosis of chronic endometritis and inflammatory changes in cytological examination of the cervix and microscopy of vaginal discharge. Comparison of the results of the above diagnostic methods can improve the diagnosis of hyperproliferative processes of the endometrium and chronic endometritis, with the further development of effective treatment methods.