KLINIKO-PATOGENETIChESKIE OSOBENNOSTI FIBROZNO-KISTOZNOY BOLEZNI MOLOChNOY ZhELEZY U PATsIENTOK S LEYOMIOMOY MATKI I ADENOMIOZOM


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Abstract

The study deals with the clinical and pathogenetic features of fibrocystic disease (FCD) in women with concomitant
gynecological diseases (uterine leiomyoma and adenomyosis). Prospective and retrospective studies were conducted
in 133 patients with FCD, including 98 patients with FCD concurrent with uterine leiomyoma and adenomyosis
and 35 women without uterine pathology (uterine leiomyoma and/or adenomyosis). Pathomorphological and
immunohistochemical studies were performed.
The patients with FCD concurrent with uterine leiomyoma and adenomyosis showed the higher proliferative
activity of the breast glandular epithelium in the foci of FCD as judged from Ki-67; the higher production of
epidermal growth factor and its receptor, as well as increased insulin-like growth factor II receptor expression.
The relative autonomy of FCD was revealed in patients with concomitant uterine leiomyoma and adenomyosis
due to the expression of estrogen receptors and possible endogenous estradiol (COX-2) synthesis, which in
combination with high progesterone receptor levels potentiates proliferation. The study indicated that FCD in
women with concomitant gynecological diseases (leiomyoma and adenomyosis) was characterized by clinical,
ultrasound, morphological, and immunohistochemical features. The frequent concurrence of breast and uterine
diseases is due to the common, identical links of their pathogenesis: the enhancement of proliferative, angiogenic activity and the specific features of progesterone and estrogen receptor expression. The detection of endo- and
myometrial pathological processes is a guide for a more careful diagnostic search for pathological processes in
the breast. The patients with concomitant breast and uterine diseases should be referred to a higher risk group
for reproductive cancers.

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