ОСОБЛИВОСТІ ЦИТОМОРФОЛОГІЧНОГО МЕТОДУ ДОСЛІДЖЕННЯ АТИПОВИХ ЗАЛОЗИСТИХ КЛІТИН НЕЯСНОГО ЗНАЧЕННЯ ЕНДОЦЕРВІКСУ ТА ЕНДОМЕТРІЯ У ЖІНОК З БЕЗПЛІДДЯМ

Abstract

Goal of the study: To determine the effectiveness of the cytomorphological study of nuclei of atypical glandular cells not otherwise specified in women with infertility. Materials and methods: A total of 240 women with infertility and pathological processes of epithelium of the genitals with atypia of cells not otherwise specified (main group) were examined. The control group consisted of 100 women with infertility and no pathological processes of the glandular epithelium of the genitals with atypia of cells not otherwise specified.All patients underwent special research methods, which included cytological, bacterioscopic and bacteriological examination and АCR (accelerated chain reaction) diagnosis of urogenital tract infections. After the etiopathogenetic treatment, women of the main group were cytomorphologically investigated nuclei of atypical glandular cells of unclear significance, as well as cervicogistroscopy in order to visualize the mucous membrane of the entire length of the mucous membrane of the cervical canal.Results. In 35.0 % of patients with infertility and the presence of pathological processes of the genital epithelium of the genitals with atypia of cells not otherwise specified by АCR, sexually transmitted infections (STIs) were detected against 13.0 % in the comparison group (p < 0.05). 40.0 % of women in the main group were diagnosed with HIV infection with STIs against 5.0 % in the comparison group, and the presence of HPV mono- infection in 25.0 % of patients versus 8.0 %, respectively (p < 0.05). Following etiopathogenetic treatment, a control cytological examination of AGC-NOS revealed 72.1 % of the patient. Atypical glandular cells not otherwise specified were identified in 63.1 % of those with previously diagnosed STIs, in 87.5 % of women with HPV mixed HIV infection and in 60.0 % with HPV mono-infection.As a result of cytomorphological study of atypical glandular cell not otherwise specified, 59.5 % of the investigated revealed the presence of glandular cells with an atypical nucleus of small size and one or two single polymorphic nucleus, indicating endometrial pathology and 40.5 % of women with atypical nuclei up to five polymorphic macronuclei in cells, which is a sign of endocervical pathology. According to histological data (endometrial pathology was determined in 58.4 % of cases in the main group versus 7.0 % in the comparison group. Pathological processes of the glandular epithelium of the cervical canal were detected in 38.2 % of the studied main group against 4.0 %, respectively.Conclusions. In women with infertility and the presence of pathological processes of epithelium of the genitals with atypical glandular cells not otherwise specified, compared with patients of the comparison group, STIs and HPV are more likely to be more frequent, both mono-infection and in association. In 96.5% of cases, the coincidence of the results of cytomorphological examination of nuclei of atypical glandular cells not otherwise specified with histological examination of biopsy pathological areas revealed during cervical hysteroscopy.