Peculiarities of intrauterine pathological processes in women of the postmenopauseal period
Abstract
Aim of the research is studying the pecularities of the endometrium pathological processes in postmenopausal women on the basis of the hysteroscopy data evaluation, as well as conduction of histopathological and immunochemical studies.
Materials and methods. To study the pecularities of intrauterine pathological processes, 100 postmenopausal women were selected and studied. All women underwent hysteroscopy with separate diagnostic scraping of the uterine cavity. Also, 10 samples of glandular-fibrous endometrial polyps (GFEP) in women of reproductive age and 9 samples of such pathology in the postmenopausal period were studied by immunohistochemical method, using 6 primary specific monoclonal antibodies.
Results. The results showed that in 64 (64 %) postmenopausal women pathological changes of the endometrium were presented with GFEP, and in 2 patients (2 %) endometrial adenocarcinoma was found. It was also determined that the nuclei of epithelial and stromal cells of GFEP in postmenopausal women are characterized by lower expression of estrogen and progesterone receptors, compared with women with such formations in the reproductive age. In addition, it was found that in postmenopausal women the expression of the apoptosis inhibitor bcl-2 and aromatase P450 in the epithelial and stromal cells of GFEP was more expressed, and the expression of the Bах antigen, on the contrary, was significantly lower than in women of reproductive age.
Conclusions. Fundamental molecular-biological differences of GFEP in postmenopausal women compared with women of reproductive age were revealed. It was found that in postmenopausal women there is a significantly lower dependence of such polyps on the effects of estrogen and progesterone. In addition, the data indicate an increased risk of neoplastic transformation in such women.
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Bueloni-Dias, F. N., Spadoto-Dias, D., Delmanto, L. R. M. G., Nahas-Neto, J., Nahas, E. A. P. (2016). Metabolic syndrome as a predictor of endometrial polyps in postmenopausal women. Menopause, 23 (7), 759–764. doi: http://doi.org/10.1097/gme.0000000000000616
Morice, P., Leary, A., Creutzberg, C., Abu-Rustum, N., Darai, E. (2016). Endometrial cancer. The Lancet, 387 (10023), 1094–1108. doi: http://doi.org/10.1016/s0140-6736(15)00130-0
Costa-Paiva, L., Godoy, C. E., Antunes, A., Caseiro, J. D., Arthuso, M., Pinto-Neto, A. M. (2011). Risk of malignancy in endometrial polyps in premenopausal and postmenopausal women according to clinicopathologic characteristics. Menopause, 18 (12), 1278–1282. doi: http://doi.org/10.1097/gme.0b013e31821e23a1
Günakan, E., Atak, Z., Albayrak, M., Kurban, Y., Şimşek, G. G. (2018). Endometrial histopathology results and evaluation of endometrial cancer risk in geriatric women. Menopausal Review, 17 (1), 18–21. doi: http://doi.org/10.5114/pm.2018.74898
Pinheiro, A., Antunes, A., Andrade, L., De Brot, L., Pinto-Neto, A. M., Costa-Paiva, L. (2014). Expression of hormone receptors, Bcl-2, Cox-2 and Ki67 in benign endometrial polyps and their association with obesity. Molecular Medicine Reports, 9 (6), 2335–2341. doi: http://doi.org/10.3892/mmr.2014.2125
Banas, T., Pitynski, K., Mikos, M., Cielecka-Kuszyk, J. (2018). Endometrial Polyps and Benign Endometrial Hyperplasia Have Increased Prevalence of DNA Fragmentation Factors 40 and 45 (DFF40 and DFF45) Together With the Antiapoptotic B-Cell Lymphoma (Bcl-2) Protein Compared With Normal Human Endometria. International Journal of Gynecological Pathology, 37 (5), 431–440. doi: http://doi.org/10.1097/pgp.0000000000000442
Adomaitiene, L., Nadisauskiene, R., Nickkho-Amiry, M., Cizauskas, A., Palubinskiene, J., Holland, C., Seif, M. W. (2020). Tumor Suppression in Asymptomatic Postmenopausal Endometrial Polyps. Anticancer Research, 40 (2), 789–794. doi: http://doi.org/10.21873/anticanres.14010
Cavkaytar, S., Kokanali, M. K., Ceran, U., Topcu, H. O., Sirvan, L., Doganay, M. (2014). Roles of Sonography and Hysteroscopy in the Detection of Premalignant and Malignant Polyps in Women Presenting with Postmenopausal Bleeding and Thickened Endometrium. Asian Pacific Journal of Cancer Prevention, 15 (13), 5355–5358. doi: http://doi.org/10.7314/apjcp.2014.15.13.5355
Vicennati, V., Garelli, S., Rinaldi, E., Rosetti, S., Zavatta, G., Pagotto, U., Pasquali, R. (2015). Obesity-related proliferative diseases: the interaction between adipose tissue and estrogens in post-menopausal women. Hormone Molecular Biology and Clinical Investigation, 21 (1), 75–87. doi: http://doi.org/10.1515/hmbci-2015-0002
Tsuzuki, Y., Kikuchi, I., Nojima, M., Yoshida, K., Hashizume, A., Tomita, S. (2017). A Case Report: Ovarian Sertoli-Leydig Cell Tumor With Hyperestrogenism and Endometrial Hyperplasia in a Postmenopausal Woman. Japanese Clinical Medicine, 8. doi: http://doi.org/10.1177/1179066017695239
Otify, M., Fuller, J., Ross, J., Shaikh, H., Johns, J. (2014). Endometrial pathology in the postmenopausal woman – an evidence based approach to management. The Obstetrician & Gynaecologist, 17 (1), 29–38. doi: http://doi.org/10.1111/tog.12150
Siegel, R. L., Fedewa, S. A., Miller, K. D., Goding-Sauer, A., Pinheiro, P. S., Martinez-Tyson, D., Jemal, A. (2015). Cancer statistics for Hispanics/Latinos, 2015. CA: A Cancer Journal for Clinicians, 65 (6), 457–480. doi: http://doi.org/10.3322/caac.21314
Elfayomy, A. K., Habib, F. A., Alkabalawy, M. A. (2012). Role of hysteroscopy in the detection of endometrial pathologies in women presenting with postmenopausal bleeding and thickened endometrium. Archives of Gynecology and Obstetrics, 285 (3), 839–843. doi: http://doi.org/10.1007/s00404-011-2068-6
Genc, M., Genc, B., Sahin, N., Celik, E., Turan, G. A., Gur, E. B., Guclu, S. (2014). Endometrial pathology in postmenopausal women with no bleeding. Climacteric, 18 (2), 241–245. doi: http://doi.org/10.3109/13697137.2014.944152
Dubossarskaya, Z. M., Greek, L. P. (2014). Rationale for treatment of patients with «proliferative syndrome» in gynecology. Zdorove zhenschiny, 3, 145–148.
Shcherbyna, M. O., Viesich, T. L., Shcherbyna, I. M., Taravnekh, D. Sh. (2017). The state of endometrial receptors at hyperplastic processes in perimenopausal women. Mizhnarodnyi medychnyi zhurnal, 23 (2), 37–40.
Antunes, A., Vassallo, J., Pinheiro, A., Leão, R., Neto, A. M. P., Costa-Paiva, L. (2014). Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps: A comparison between benign and malignant polyps in postmenopausal patients. Oncology Letters, 7 (6), 1944–1950. doi: http://doi.org/10.3892/ol.2014.2004
Troncon, J. K., Meola, J., Candido-dos-Reis, F. J., Poli-Neto, O. B., Nogueira, A. A., Rosa-e-Silva, J. C. (2017). Analysis of differential genetic expression in endometrial polyps of postmenopausal women. Climacteric, 20 (5), 462–466. doi: http://doi.org/10.1080/13697137.2017.1335701
Polishchuk, T. P. (2020). Prophylaxis of relapses for the women of postmenopausal period with of high quality pathology of endometrium. Reproductive health of woman, 3, 24–27. doi: http://doi.org/10.30841/2708-8731.3.2020.215008
Tingting, S. U., Sui, L. (2014). Expression and significance of p63, aromatase P450 and steroidogenic factor-1 in endometrial polyp. Chinese Journal of Obstetrics and Gynecology, 49 (8), 604–608.
Artymuk, N. V., Gulyaeva, L. F., Zotova, O. A. (2012). Metabolism peculiaritirs and estrogenes reception in endometrial hyperplasia and endometriosis. Mat i ditya v Kuzbasse, 1, 8–12.
Copyright (c) 2021 Tetiana Polishchuk, Serhii Vdovichenko , Oleksandra Lubkovska, Dmytro Ledin

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