Endometrial lesion’s pattern in different age groups

Abstract

Background. Endometrial polyps (EP) take an important part in the structure of intrauterine pathology and could be associated with abnormal uterine bleeding (AUB), infertility and the risk of endometrial cancer (EC) development. The data concerning EP's prevalence and combination with other endometrium pathology's forms in women of different age varies widely. It causes difficulties for understanding the magnitude of the problem and finding solutions for management. Aim. To evaluate the prevalence of EP and other endometrium conditions at different ages. Materials and methods. Based on the study of 4059 histological samples we analysed the EP's prevalence and association with other intrauterine pathology in women of different age groups. Results. EP was diagnosed in 27.4% of samples. It's frequency varied from 21.7 to 27.3% in reproductive age and-45% in postmenopausal women. 19.8% of EP were concomitant with chronic endometritis (CE), 3.7% with endometrial hyperplasia (EH). Conclusions. EP take 1st place in the structure of intrauterine pathology during all age periods. Their prevalence is 2.7 times higher than CE, and 4.5 times higher than EH.

The retrospective analysis results of the endometrial tissue pathological conditions development

“…This period is considered the "perimenopausal estrogen window", or the period of "uncovered" estrogenic effects on the endometrium. It is from this age that the fact of increasing the frequency of adenocarcinoma begins [1,12,23,25].…”

“…Cell senescence is a genetically programmed process that should eventually lead to apoptosis [9,12], manifested by irreversible blockade of the division cycle, cessation of cell response to pro-liferation stimuli, and growth factors in the presence of critically shortened telomeres and unrepaired DNA damage [7], as the accumulation of genetic heterogeneity is the main property of malignant tumors, the protection against malignancy is sending to apoptosis cells with the expression of mutant genes [9,10].…”

“…Proliferation is considered a factor that contributes to the development of genetic damage, often not taking into account that in cells of rapid division, genetic damage can occur more often, but they are more often eliminated [6,10,11]. There are works that indicate the leading factors of the mutation process that must be sought within a living organism and a living cell [7,12,13].…”

“…Endometrial cancer (EC) occupies a leading position in the structure of oncogynecological pathology in economically developed countries, which involves the study of various etiopathogenetic mechanisms of endometrial pathology neoplasia [2,12,14], as well as the search for basic mechanisms, that at different levels of cellular regulation processes, can contribute to the acquisition of characteristic properties for further neoplastic growth [15,16,17].…”

“…According to various publications, EHP is rated from 15% to 50% among gynecological diseases in general with no tendency to decrease [6,7,20]. This variability of indicators depends on age, environmental, medical and social health problems in different countries, factors that provoke the development of cancer, especially endocrine regulation and iatrogenic factors [12,21,22]. There is an increase in the occurrence of atypical EHP and EC in the reproductive period, which encourages researchers to carry out a program of cancer prevention and development of early diagnostic markers, treatment measures on the background of various morphological aspects [13,20,23].…”