Репозиторий Университета

© Bionika Media Ltd. Objective. To carry out a systems analysis of the data available in the current literature on the impact of vitamin D deficiency on the risk of endometriosis and reproductive cancer, as well as on the possibilities of vitamin D supplementation in order to treat and prevent these diseases. Material and methods. The review includes the data of foreign and Russian articles published in the past 10 years and found in Pubmed on this topic. Results. The paper describes the mechanisms by which vitamin D is involved in the processes of inflammation, immunomodulation, and proliferation, as well as the role of its deficiency in pathogenesis of pathological proliferation and inflammation in endometriosis, breast cancer, and ovarian cancer. It gives the data of clinical trials confirming the role of vitamin D deficiency in the progression and negative effects of endometriosis and carcinogenesis, the possibility of vitamin D supplementation for the prevention and adjunct therapy of reproductive cancer and endometriosis. Conclusion. It is necessary to conduct further studies to experimentally and clinically evaluate vitamin D deficiency in endometriosis and cancer. Currently, vitamin D supplements should be prescribed to patients with this pathology if they have been found to have a low blood level of 25(OH)D3.

© Bionika Media Ltd. Endometriosis affects up to 15% of reproductive-aged women. Consideration of this nosological entity in a new aspect is impelled by the evidence that 0.5–1% of cases develops endometriosis-associated ovarian neoplasms that are more represented by the endometrioid and clear-cell subtypes of tumors. This category also includes seromucinous ovarian tumors (SMOTs). Objective. To investigate the morphological and immunohistochemical (IHC) features of SMOTs in reproductiveaged women, including pregnant ones. Subjects and methods. Ovarian tumor samples from 15 patients who had been operated on in 2012-2016 were analyzed comprehensively at the National Medical Research Center of Obstetrics, Gynecology, and Perinatology: IHC examination was conducted using the biomarkers of estrogen and progesterone receptors and Ki-67. Results. Borderline SMOTs were characterized by papillary growths on the inner surface (in one case) and on the outer surface, with an adhesive process with the serous surface of the corpus uteri (FIGO Stage 1c), and mixed epithelial structures; leukocyte infiltration was observed in 4 cases. The epithelium of seromucinous carcinoma (n = 1) was similar to that of serous, endocervical, and endometrial types at the same time. All the samples exhibited a low Ki-67 expression and high positive receptor immunoreactivity. Endometriosis diagnosed in nine women was accompanied by benign seromucinous cystadenomas (n = 4), borderline tumors (n = 4), and carcinoma (n = 1). Conclusion. Most of the examined SMOTs showed the areas, covered with the endometrioid epithelium, with adjacent endometrial stroma, which indicated the development of carcinoma in the presence of endometrioid cyst. The revealed facts suggest that endometriosis plays an etiological role in developing SMOTs. When detected, most neoplasms are localized (limited to ovarian tissue, FIGO stage 1a) and characterized by a favorable prognosis as a whole.

© 2018 Media Sphera Publishing Group. All rights reserved. Objective - to study endometrial receptivity in infertile women with external genital endometriosis (EGE). Subject and methods. Clinical, morphological, immunohistochemical, and molecular genetic examinations of endometrial aspiration pipelle biopsy specimens obtained on days 22-24 of the menstrual cycle from 94 infertile women with endometriosis: 50 women with Stage I-II EGE and 44 women with ovarian endometrioid cysts (OEC). A control group consisted of 54 women with tubal peritoneal factor of infertility (TPFI) and a successful attempt at IVF. Hematoxylin and eosin-stained sections were found to contain a number of endometrial surface epithelial cells containing mature pinopods. The expression levels of leukemia inhibitory factor (LIF), HOXA-10, glycodelin A, avβ3 integrin, estrogen receptors (ER) and progesterone receptors (PR), aromatase in the superficial epithelium, glandular epithelium and endometrial stroma were immunohistochemically revealed. Forty-four patients, including 17 with Stage I-II EGE and 27 with TPFI, showed mRNA expression levels of leukemia inhibitory factor receptor (LIFR), LIF, ER1, PgR, HOXA-10, and PTEN by real-time quantitative polymerase chain reaction (PCR) with a preliminary reverse transcription PCR assay. Results. It was established that in the infertile women with Stage I-II EGE and those with OEC, endometrial receptivity was impaired, which was manifested by a decline in the number of superficial epithelial cells containing mature pinopods, as well as a decrease in the endometrial level of the key receptivity markers: αvβ3 integrin, LIF, glycodelin A, and HOXA10 and increases in the synthesis of aromatase and in the imbalance of endometrial stromal expression of ER and PR detected by immunohisto chemistry (IHC). Molecular genetic study showed lower mRNA expression levels of the HOXA-10, LIFR, and PgR genes, which confirms the data obtained by IHC. Conclusion. To assess the role of the endometrium in the development of infertility in women with EGE, it is necessary to conduct morphological and IHC studies of the molecular markers of receptivity, by determining the status of pinopods of the endometrial surface epithelium during the window of implantation.

© 2018, Bionika Media Ltd. All rights reserved. Objective. To investigate the signs of neoplastic transformation of the epithelium in the foci of ovarian endometriosis (OE). Material and methods. Histological and immunohistochemical examinations were used to study 78 and 35 OE cases, respectively, and 8 adenocarcinomas. Anti-Ki-67, anti-Bcl-2, anti-p53, and anti-hepatocyte nuclear factor-1β (HNF-1s) antibodies were employed. Results. The epithelium of endometrioid cyst walls showed papillary syncytial changes (39.7%), metaplasia with clear cytoplasm сells (15.4%), and epithelial atypia with a low-to-relatively low Ki-67 and Bcl-2 expression and with a low p53 expression (41.0%). The expression of HNF-1β in the foci with and without atypia was revealed in 94.7 and 56.3% of cases, respectively; it was detected only in clear cell adenocarcinomas. Conclusion. HNF-1s hyperexpression suggests the adaptive nature and histogenetic relationship of OE to clear cell tumors of the ovary.

© Bionika Media Ltd. The article highlights the clinical and pathogenetic relationships between endometriosis/adenomyosis and chronic endometritis (CE) within reproductive failures. It describes a cause-and-effect relationship between endometriosis/ adenomyosis and CE by the example of its clinical symptomatology and the pathogenic mechanisms involving an autoimmune process, aseptic inflammation, and altered endometrial receptivity. Endometriosis/adenomyosis and CE have a number of common pathogenetic mechanisms of development and clinical manifestations (infertility, miscarriages, and assisted reproductive program failures). This implies the necessity to qualitatively assess the endometrium in women with endometriosis and adenomyosis during pregravid preparation, as well as the search for new therapeutic ways to correct autoimmune disorders. The use of sodium desoxyribonucleate (derinat) showing the pharmacological properties of an activator of the cellular and humoral immune system and a stimulator of reparative and regenerative processes is a promising approach to drug therapy.