MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL CHANGES OF THE ENDOMETRIUM IN WOMEN WITH HYPERPROLIFERATIVE PATHOLOGY OF THE UTERUS AND REPRODUCTIVE DYSFUNCTION

Keywords: endometrial hyperplasia, endometrial polyps, uterine fibroids, ultrasound, hysteroresectoscopy

Abstract

Hyperproliferative pathology of the uterus (HPЕ) occupies one of the leading places in the structure of female infertility, leading to women’s generative dysfunction in 80% of cases.

The aim of the study: to assess the immunohistochemical and morphological features of the endometrium in patients with hyperproliferative pathology of the endometrium and infertility.

Materials and methods. Forty endometrial samples from women with infertility and hyperproliferative pathology of the endometrium were examined: 20 samples of endometrium obtained from women with infertility and endometrial polyps (1 group) and 20 samples obtained from women with infertility and endometrial hyperplasia without atypia. The endometrium of 20 healthy women was examined as the control group.

Pipelle biopsy of the endometrium was performed in the luteal phase of the menstrual cycle in women of the main and control groups to obtain the material. The morphological and immunohistochemical features of the endometrium in women with infertility and hyperproliferative pathology of the endometrium were determined.

Histogram sections were stained with hematoxylin and eosin, and picrofuxin (Van Gizon’s stain). An immunohistochemical study was performed with the polymer detection method of antigen application using the UltraVisionQuanto peroxidase polymer and DAB plus chromogen detection system to determine the expression of monoclonal antibodies to estrogen and progesterone receptors, natural killers СD-56 and СD-138.

The results of the investigation. Morphological examination of the endometrium of women with infertility and hyperproliferative pathology of the endometrium revealed a number of pathological changes: glandular and glandular-fibrous polyps of the endometrium (70–80%), atypical endometrial hyperplasia (10–20%), dyschronosis of endometrial receptivity (40–50%), morphological signs of chronic endometritis, positive expression of CD-138 (10%), as well as their combination.

Conclusions. Women with infertility and hyperproliferative pathology of the uterus and unsuccessful attempts at ART have expressed dyshronosis of receptivity of the endometrium on the background of reduced expression of endometrial natural killers and positive expression of CD-138. It is indicative of the dysregulation of immunological homeostasis on the local level, which may be the cause of disruption of blastocyst implantation processes, unsuccessful attempts of ART and lead to early pregnancy loss.

Author Biography

Kseniia Mуkуtуn, Department of Obstetrics, Gynecology, and Family Planning, Sumy State University, Sumy, Ukraine

Postgraduate student of the Department of Obstetrics, Gynecology and Family Planning, Sumy State University, Sumy, Ukraine;

ORCID: http://orcid.org/0000-0001-9620-550X

e-mail: kseniya030894@gmail.com

tel: +380662947360

References

1. Gorban NY, Vovk IB, Hoida NH et al. Menstrual dysfunction: the situation in the world and in Ukraine – in women of reproductive age and with atypical hyperproliferative pathology of the endometrium. Bull. Soc. Hygiene Health Protect. Organiz. Ukraine. 2019;(3):77-83.
2. Boychuk AV, Vereshchahina TV, Nikitina IM. Estimation of relative risk of development and informativeness of diagnostic metods of hiperproliferative processes of endometrium. Wiadomości Lekarskie. 2020;LXXIV(9):1600–09.
3. Boichuk AV, Shadrina VS, Vereshchahina TV. Hyperplasia of endometrium – a modern system-pathogenetic view on the problem (literature review): (literature review). Actual problems of pediatrics, obstetrics and gynecology, 2019;(1):67-72. doi: 10.11603/24116- 4944.2019.1.9906.
4. Gorban NY, Vovk IB, Nikitina IM, Yemets NV. Immunoglobulin indicators to viruses citomegal and genital herpes in the blood serum of women with non-atipycal endometrial hiperproliferative pathology. Wiadomości Lekarskie. 2020;LXXIII(8):1600–1605.
5. Moreno I, Cicinelli E, Garcia-Grau I et al. The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am. J. Obstet. Gynecol. 2018;218(6):602-09.
6. Kalenska OV, Demchenko OM, Spivak MY, Bubnov R, Goncharenko V. Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age. EPMA J. 2013;4(24):
7. Nikitina IM, Gorban NY, Mуkуtуn KV, et al. The state of reproductive health of women with hyperproliferative pathology of the endometrium. Wiadomości Lekarskie. 2021;LXXIV(9):2076-81. doi: 10.36740/WLek202109109.
8. Wu Q, Chu Z, Han H. Primary squamous cell carcinoma of the endometrium in a woman of reproductive age: a rare case report. J. Int. Med. Res. 2018;46(8):3417-3421. doi:10.1177/0300060518776579.
9. Rintala M, Vahlberg T, Salo T et al. Proliferative verrucous leukoplakia and its tumor markers: Systematic review and meta-analysis. Head Neck. 2019;41(5):1499-1507. doi:10.1002/hed.25569.
10. Tetikkurt S, Çelik E, Taş H et al. Coexistence of adenomyosis, adenocarcinoma, endometrial and myometrial lesions in resected uterine specimens. Mol. Clin. Oncol., 2018;9(2):231-37. doi:10.3892/ mco.2018.1660
Published
2022-09-30
How to Cite
Kseniia Mуkуtуn. (2022). MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL CHANGES OF THE ENDOMETRIUM IN WOMEN WITH HYPERPROLIFERATIVE PATHOLOGY OF THE UTERUS AND REPRODUCTIVE DYSFUNCTION. Eastern Ukrainian Medical Journal, 10(3), 241-246. https://doi.org/10.21272/eumj.2022;10(3):241-246