EVALUATION OF THE FUNCTIONAL STATUS OF THE CORPUS UTERI MUCOSA IN PATIENTS WITH ENDOMETRIAL HYPERPLASTIC PROCESSES

Objective. To study the expression of progesterone and estrogen-a receptors (PgR and ER-a) in the presence of endometrial hyperplastic processes, by using an immunomorphological study. Material and methods. Comprehensive immunomorphological study was conducted to examine the expression of ER-a and PgR in 95 endometrial scrapes obtained during separate diagnostic uterine curettage in women aged 45 to 56 years (mean age 48.4±2.8 years). Endometrial samples were assigned to the following groups: the unaltered endometrium in the proliferative phase in 15 cases; simple endometrial hyperplasia in 15; complex endometrial hyperplasia in 15; atypical hyperplasia in 15; endometrial hyperplasia concurrent with chronic endometritis in 20; and chronic endometritis with reactive endometrial hyperplasia in 15. Results. The expression of ER-a and PgR in the gland epithelium, and stromal cells in particular, was decreased in simplex and complex endometrial hyperplasia (irrespective of the signs of acute reactive inflammation) was the least in atypical (simplex and complex) hyperplasia, by showing evident nonuniformity within the same glands and different stromal areas. In simple hyperplasia complicated by chronic endometritis, ER-a and PgR expression did not significantly differ from that in simple and complex hyperplasia. In chronic endometritis with reactive endometrial hyperplasia, the expression was pronounced in the gland epithelium and irregular in the stromal cells (in the average, this was significantly below that in the observations in the proliferative phase and in simple hyperplasia). Conclusion. The was a significantly lower ER-α и PgR expression in the stromal cells, which was decreased in the epithelium of the glands in endometrial hyperplasia concurrent with chronic endometritis versus simple and complex hyperplasia, which should be kept in mind while choosing an agent for conservative hormonal therapy.

estrogen-α receptors, progesterone receptors, endometrial hyperplasia, chronic endometritis