MOLECULAR BIOLOGICAL FEATURES OF ENDOMETRIAL HYPERPLASTIC PROCESSES

Objective. To study the molecular biological features of endometrial hyperplastic processes. Subject and methods. A prospective study was conducted in 1490 patients, including 620 women with a histologically verified endometrial hyperplastic process (a study group) and 870 patients without endometrial pathology (a comparison group). After a comprehensive immunomorphological study, the investigators formed 5 study groups: 1) 248 women with simple endometrial hyperplasia without atypia; 2) 94 with complex endometrial hyperplasia without atypia; 3) 42 patients with simple and complex endometrial hyperplasia with atypia; 4) 142 with endometrial hyperplastic processes concurrent with chronic endometritis; 5) 94 with chronic endometritis and reactive endometrial hyperplasia. Results. The early stages of development of abnormal endometrial processes (simple and complex hyperplasia without atypia) were marked by a trend toward decreased apoptosis and enhanced sclerosing activity (elevated transforming growth factor-ß1 (TGFß1) levels), as in the gland epithelium. With the progression of the process (chronic endometritis concurrent with simple endometrial hyperplasia and reactive hyperplasia), there was inhibition of apoptosis and the extracellular matrix exhibited the actively ongoing processes of stromal formation and neoangiogenesis (the high production and accumulation of LOX), fibronectin, vascular endometrial growth factor, and TGFß1). Conclusion. The found features of the molecular biological profile of endometrial hyperplasia concurrent with chronic endometritis are suggestive of enhanced cellular proliferative activity, intensive growth factor expression, activated sclerosis and angiogenesis, proving the role of an inflammatory factor in the creation of optimal conditions for tumor transformation of endometrial tissue.

endometrial hyperplastic processes, chronic endometritis, vascular endometrial growth factor, transforming growth factor-β1, fibronectin, lysyl oxidase