THE DETECTION RATE AND THE STRUCTURE OF PATHOLOGICAL CHANGES OF THE ENDOMETRIUM IN WOMEN OF REPRODUCTIVE AGE WITH ENDOMETRIOSIS


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Abstract

Objective. To determine the frequency of various pathological changes in the endometrium of reproductive-aged women with endometriosis Subjects and methods. The endometrium was sampled from 236 patients: 118 women with endometriosis and 118 without this condition (a comparison group) and morphologically examined by the conventional procedure. Immunohistochemical (IHC) examination used monoclonal antibodies against CD 138 (RTU, clone D0-7, Dako, Denmark) and PTEN (clone 6H2.1, dilution 1:100). The Dako REAL EnVision Detection system (Dako, Denmark) was used as secondary antibodies. To visualize antibody-antigen binding sites, the investigators applied the oxidation reaction of 3,3-diaminobenzidine by horseradish peroxidase in the presence of hydrogen peroxide to form a water-insoluble brown end product. After carrying out IHC reactions, the sections were counterstained with hematoxylin and mounted using the Shandon mount™ synthetic medium (USA). Negative and positive controls were used to correctly carry out IHC tests. Results. The level of pathological changes in the endometrium was considerably higher in the endometriosis group than that in the non-endometriosis one (50% vs 27.1%). Chronic endometritis was diagnosed in 22.03% (26/118) of cases in the endometriosis group and in 11.02% (10/118) in the non-endometriosis group. Endometrial polyp was detected in 17.8% (21/118) of cases among the patients with endometriosis and in 8.47% (10/118) among those in the comparison group. Endometrial hyperplasia was diagnosed in 10.17% (12/118) in the patients with endometriosis and in 7.63% (9/118) among those in the comparison group. However, there were no statistically significant differences in the frequency of pathological changes in the endometrium between the early (I+II) and late (III+IV) stages of endometriosis. Conclusion. Our study has shown that the frequency of pathological changes, such as chronic endometritis and endometrial polyp, is higher among the patients with genital endometriosis than among those without this disease. The emergence of endometrioid foci is closely related to pathological changes in the endometrium; however, the sequence of occurrence of pathological changes in the uterus and small pelvic cavity remains unclear and will be the subject of our further investigations.

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About the authors

Ekaterina Yuryevna Tikhonchuk

Email: best-kauty@mail.ru
PhD-student, Department of Surgical Gynecology, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 119997, Russia, Moscow, Ac. Oparina str. 4

Alexandra Vyacheslavovna Asaturova

Email: a_asaturova@oparina4.ru
PhD, senior scientific researcher of pathology department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia 119997, Russia, Moscow, Ac. Oparina str. 4

Leila Vladimirovna Adamyan

Email: l_adamyan@oparina4.ru
MD, professor, academician of RAS; deputy director on science, head of department of operative gynecology, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 119997, Russia, Moscow, Ac. Oparina str. 4

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