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№2' 2021

OBSTETRICS AND GYNECOLOGY

International Medical Journal, Vol. 27., Iss. 2, 2021, P. 65−69.

DOI (https://doi.org/10.37436/2308-5274-2021-2-11)

THERAPEUTIC TACTICS IN ENDOMETRIUM HYPERPLASIA WITH RESPECT TO MORPHOLOGICAL FEATURES OF ITS STRUCTURE

Kharkiv National Medical University, Ukraine

Endometrial hyperplasia is a polyetiological process, the development and progression of which can be facilitated by various factors. One of the most significant is hormonal changes in a woman's reproductive system. In endometrial hyperplasia, the changes in the receptor apparatus in its tissue are unidirectional. To study the morphological features of endometrial hyperplastic processes and the state of receptors in glandular−cystic and adenomatous endometrial hyperplasia, taking into account the tissue homeostasis, we investigated 85 women aged from 42 to 50 years. All patients underwent a comprehensive clinical examination: ultrasound, hormonal profile, morphological, histological, immunohistochemical and endosurgery. It was found that the levels of the proliferation marker Ki−67, as well as the expression of estrogen and progesterone receptors can predict the activity of the hyperplastic process. Based on the results of this study, the principles of individual therapeutic tactics in women with this pathology have been formulated. It is noted that the differential approach to treatment should be performed with respect to the levels of expression of estrogen and progesterone receptors, the clinical course of the disease and morphological state of the endometrium. Treatment should be aimed at normalizing endocrine and metabolic processes in women. The effectiveness of the proposed treatment approaches was determined by clinical observation, assessment of menstrual function, dynamic ultrasonographic monitoring, Doppler blood circulation in the basal layer of endometrium and spiral arteries, control cytological and histological studies. A rational and competent approach to the treatment of endometrial hyperplastic processes is a reserve for reducing the frequency of its oncological pathology.

Key words: endometrial hyperplastic processes, progesterone receptors, estrogen receptors, markers of proliferation, treatment tactics.

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