MODERN VIEWS ON THE PROBLEM OF HYPERPROLIFERATIVE PROCESSES OF ENDOMETRIUM (REVIEW OF LITERATURE)
DOI:
https://doi.org/10.11603/2415-8798.2018.1.8741Keywords:
hyperproliferative processes of endometrium, endometrial hyperplasia, polyp of the body of the uterus, reproductive age of a woman.Abstract
In modern gynecological practice, the hyperproliferative processes of endometrium (uterine body polyps and endometrial hyperplasia (EH )) are among the leading places in the structure of the diseases of the female genital area, with quite variable clinical symptoms, often combined with another hyperproliferative pathology of the uterus, which is extremely difficult the choice of approaches to the treatment of such cases. It is still ambiguous to quantify the links between the age-span of a woman's life and the presence of her hyperproliferative processes in the endometrium and their role in violation of reproductive health.
The aim of the study – to analyze the published results of researches of many authors devoted to the pathogenic aspects and diagnosis of hyperproliferative processes of endometrium; consider the etiology of changes which can lead to such pathology formation and their influence on tactics of patients’ leading.
Materials and Methods. The paper analyzes the etiological factors and pathogenetic factors in the occurrence of hyperproliferative processes of endometrium in women of reproductive age. The high level of combination of hyperproliferative processes of endometrium and myometrium is established. The role of hormonal imbalance, violation of the immune response in endometrial hyperplasia is determined, data on the association of uterine body polyps with chronic inflammatory processes of the female genital area caused by both microbial and viral agents are given.
Results and Discussion. In the search for possible relationships between endometrial hyperplasia and the inflammatory process, it has been found that the trigger role in the occurrence of simple endometrial hyperplasia belongs to systemic and subsequent local hypertrogaemia, while the role of inflammatory endometrial processes is more significant in the occurrence of complex and atypical endometrium hyperplasia, which can be considered as a factor in progression and development, possibly even increasing the risk of malignant transformation. Despite the large number of scientific papers devoted to the problems of endometrial hyperproliferation, the histogenetic mechanisms of the development of various pathological conditions of the endometrium (hyperplasia, polyps of the uterus body) have not yet been fully explored. Modern postulates are advised to recognize the development of hyperproliferative processes of endometrium as a result of an imbalance between the processes of proliferation and apoptosis that are regulated by cellular and extracellular components at the molecular levels. Given in relation to prevalence among the woman population of different age-dependent groups, plenty of frequency of combination of high quality hyperproliferative diseases of uterus specify on the necessity of realization of further scientific searches, volume, one of priority directions there is work from the study of nosotropic mechanisms that is preceded to the clinical displays of development of pathological processes of endometrium.
Conclusions. Thus, analyzing the data of the scientific literature concerning the etiopathogenetic factors that are the basis for the development of proliferative processes of endometrium, it can be concluded that these are complex, multi-stage, hormonal, proliferativeapoptotic and inflammatory mechanisms, the realization of which occurs not without the participation of genetic factors.
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