Goal of the study: to determine ultrasound, cervicohisteroscopic, histological and immunohistochemical signs of benign and pre-tumor pathological processes of genital epithelium with atypia of cells of unclear genesis in women with infertility. Object and methods: 173 women with infertility and pathological processes of genital epithelium with atypia of cells of unclear genesis (main group) were examined. This group included women with endocervical pathology – 70 patients and endometrium – 103 patients. All patients underwent ultrasound, cervico-hysteroscopic, histological and immunohistochemical examination. Results. The most common ultrasound signs of pathological processes of the glandular epithelium of the genitals are: thickening of the endocervix (61.4%), its heterogeneous structure (97.1%), the presence of hyperechogenic subendocervical inclusions (41.4%); endometrial thickening (73.8%) and heterogeneous endometrial structure (96.1%), presence of hyperechogenic inclusions both in the mid-M-echo area (78.6%) and in the basal layer projection (36.9%). Cervicogisteroscopic examination revealed in women with infertility and pathological processes of the glandular epithelium of the genitalia a gross folding of endocervix (70.0%), its uneven relief (77.1%) and atypia sections of endocervix (95.7%), hypertrophic (33.9%) uterine mucosa, 56.3% of uneven thickness, vascular pattern expressed (84.5%), single hemorrhages (88.3%) or massive (18.4%), endometrium unevenly colored (92.2%), polypodium growths in 36,9%. Histological examination in 83.5% of patients with infertility and endometrial pathology with atypia of cells of unclear genesis identified lympho-macrophage infiltration of stroma, fibrosis and sclerosis of the stroma, as well as sclerosis of the spiral arteries of the endometrium, and in 16.5% of examinations. In patients with endocervical pathology, 91.4% of cases were diagnosed with dysplasia of the glandular epithelium of the cervical channel of varying severity. In 83.5% of patients with infertility and endometrial pathology with atypia of cells of unclear genesis, endometritis was diagnosed when determining the expression of syndecan-1 CD138. Conclusion. Ultrasound examination reveals signs of pathological processes of the glandular epithelium of the genitals with atypia of cells of unclear genesis in women with infertility. Cervicogisteroscopy allows to evaluate the macroscopic picture of the endocervix and the endometrium and to conduct a biopsy of pathological areas. Histological examination diagnoses both benign (endocervicosis and endometritis, hyperplastic processes without atypia), and pre-tumor (dysplasia of varying severity) processes of epithelium of the genitals with atypical glandular cells not otherwise specified (AGC-NOS). Determination of CD 138 expression confirms endometritis in these women.
benign and pre-tumor pathological processes of epithelium of the genitals with atypical glandular cells not otherwise specified (AGC-NOS), infertility, cervicogistroscopy, histological examination, CD 138.
«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 68-72 pages, index UDK 618.177-02:618.1-018.7-006.03-07
