CLINICAL VALUE OF COMPREHENSIVE EVALUATION OF THE ENDOMETRIAL RECEPTOR STATUS IN ENDOMETRIAL POLYPS

Objective. to optimize treatment in patients with endometrial polyps (EP) on the basis of comprehensive evaluation of the clinical and morphological signs of the disease at reproductive age, by examining steroid hormone receptor expression, proliferative activity, and apoptosis in the polyp and adjacent endometrial tissues. Subjects and methods. Transvaginal ultrasound study, hysteroscopy, separate diagnostic curettage, histological and immunohistochemical study of the expression of α-estrogen and progesterone receptors (ER and PR), Ki-67, and bcl-2 in the glands and stroma of polyps and adjacent endometrium were performed in 43 reproductive-age women with EP and 10 control patients. Statistical processing used the Mann-Whitney test, χ 2 test, and Spearman correlation test, by employing a package of applied Statistica 6.0 programs. Results. Chronic endometritis was identified in 60% of the patients with EP. There were the following differences in the receptor apparatus of the adjacent endometrium versus the normal endometrium: ER deficiency with a relative preponderance of PR; unilateral expression of hormone receptors in the polyp and endometrial tissues; a correlation between the proliferative activity and expression of hormone receptors in both the polyp and the endometrium; a correlation of chronic endometritis with apoptosis. Conclusion. Imbalance has been found in the expression of hormone receptors in the adjacent endometrium after polypectomy that correlates with proliferation and apoptosis, which serves as a guide to anti-inflammatory rather than hormone therapy and a basis for the prevention of recurrent EP.

endometrial polyp, endometrium, α-estrogen receptors, progesterone receptors, proliferation, apoptosis