Treatment of Chronic Endometritis with Vague Symptoms in Patients with Endometrial Hyperplasia

N. I. Volotskaya, E. Golubinskaya, E. Zyablitskaya, Р. E. Maksimova
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Abstract

Aim. To develop new therapeutic approaches for chronic endometritis with vague symptoms, which is frequently diagnosed in patients with endometrial hyperplasia.Materials and Methods. We collected the material from uterine scrapings in patients (age 25-63 years) with endometrial hyperplasia (diagnosed by ultrasound examination) and abnormal uterine bleeding which occurred during hysteroscopic dilation and curettage. Among the exclusion criteria were intraepithelial neoplasia and atypical endometrial hyperplasia, cancer, systemic inflammation, and hormonal therapy. To verify the diagnosis, we employed immunohistochemistry, digital slide scanning, and morphometry.Results. This study confirmed the value of immunohistochemical diagnosis underlying the pathogenetic therapy of endometrial hyperplasia using non-steroidal anti-inflammatory drugs. Inflammatory markers indicating the distribution and quantitative alterations in cell populations had the highest diagnostic value.Conclusion. We developed a molecularly oriented algorithm for the treatment of patients with endometrial hyperplasia. This algorithm improves existing preventive, diagnostic and therapeutic approaches using immunohistochemical techniques. Such molecular testing can help in making correct therapeutic decisions.
治疗子宫内膜增生症患者症状模糊的慢性子宫内膜炎
目的针对子宫内膜增生症患者常被诊断出的症状模糊的慢性子宫内膜炎,开发新的治疗方法。我们收集了子宫内膜增生(通过超声波检查确诊)患者(25-63 岁)的子宫刮片材料,以及在宫腔镜扩张和刮宫术中出现的异常子宫出血。排除标准包括上皮内瘤变和非典型子宫内膜增生、癌症、全身性炎症和激素治疗。为了验证诊断结果,我们采用了免疫组化、数字玻片扫描和形态测量等方法。这项研究证实了免疫组化诊断在使用非甾体抗炎药治疗子宫内膜增生症的病理基础上的价值。表明细胞群分布和定量改变的炎症标记物具有最高的诊断价值。我们为子宫内膜增生症患者的治疗制定了分子导向算法。该算法利用免疫组化技术改进了现有的预防、诊断和治疗方法。这种分子检测有助于做出正确的治疗决定。
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