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Clinico-pathogenetic features of hyperplastic endometrial processes in women of perimenopausal age

Abstract


Unanyan A.L., Sidorova I.S., Kogan E.A., Baburin D.V.

Sechenov University, Moscow

The aim of the study was to reveal the most significant clinico-anamnestic and molecular risk factors for the onset, progression of endometrial hyperplastic processes and development of malignant transformation of endometrium in women of perimenopausal age, taking into account statistical analysis.
Patients and Methods: based on Spearman rank correlation analysis and the degree of dependence of the development of endometrial cancer (from 0 to 1) on clinical-anamnestic, diagnostic and molecular-biological risk factors (RR by groups), coefficients for a mathematical model were obtained which allowed to predict the risk of endometrial cancer using the method of binary logistic regression.
Results: the most significant clinico-anamnestic and diagnostic risk factors for the progression of the pathological process of the endometrium, which have a high RR value (higher than 1) and a confidence interval of 95% (p <0.05), are: recurrence of endometrial hyperplastic processes (EHP), obesity, significant blood flow in ultrasound imaging with CDI, polycystic ovarian syndrome (POS), ovarian pathologies, infertility (primary and secondary), type 2 diabetes mellitus, combined uterine pathology (myoma and / or adenomyosis), hereditary load of oncological diseases, hypertension, age 50 years and older. In our work, we studied the most promising immunohistochemical markers evidencing the involvement of differentiation of endometrial stem cells into the progression of the pathological process and malignant transformation of the endometrium — ALDH1A1, MUSASHI1, Oct4, CD117, HOXA10.
Conclusion: the results obtained during our work allowed us to identify statistically significant risk factors for the development of endometrial cancer. The coefficients were obtained to create a reliable mathematical model. Using the method of binary logistic regression, it is possible to calculate the risk of developing cancer and choose an effective management tactic for patients with hyperplastic endometrial processes in the perimenopause.

Key words: endometrial hyperplastic process, endometrial hyperplasia, endometrial cancer, risk factors, perimenopause, cancer prediction, stem cells.
For citation: Unanyan A.L., Sidorova I.S., Kogan E.A., Baburin D.V. Clinico-pathogenetic features of hyperplastic endometrial processes in women of perimenopausal age // RMJ. Medical Review. 2018. № 1(I). P. 67–71.
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