Modern approaches to the diagnosis of endometrial hyperplasia

Introduction. In recent years, there has been an increase in the frequency of various nosological forms of endometrial hyperplasia, which is diagnosed in 38-72% of women of reproductive age. The information content of the applied instrumental diagnostic methods ranges from 47 to 89%. In the pathogenesis of endometrial hyperplasia, an important role is played by the imbalance of the processes of proliferation, differentiation and death of cells.
The aim of the study. This review aims to study the information content of instrumental diagnostic methods in patients with different types of endometrial hyperplasia, as well as to analyze some indicators of apoptosis in the blood and endometrial tissue in patients with endometrial hyperplasia without atypia and in patients with atypical endometrial hyperplasia.
Object and methods. A comprehensive clinical, instrumental and biochemical study was conducted on 36 patients of reproductive age (mean age 45.7±3.41 years) with different types of endometrial hyperplasia. All patients were examined using clinical, echographic, hysteroscopic and morpho-biochemical methods. The patients were divided into two groups. Group 1 included 25 (69.4%) patients with endometrial hyperplasia without atypia; Group 2 included 11 (30.6%) patients with atypical endometrial hyperplasia. A comparative analysis of the diagnostic methods used was conducted and compared with the morphological method.
Results and its discussion. A study of some indicators of apoptosis in the blood and endometrial tissue in patients from the studied groups was performed. It was noted that patients with endometrial hyperplasia without atypia and atypical endometrial hyperplasia had a violation of the regulation of cellular homeostasis due to an imbalance of apoptosis factors and cell proliferation.
Conclusion. A decrease in the concentration of factors initiating apoptosis is accompanied by a decrease in the induction of programmed endometrial cell death. Dysregulation of apoptosis leads to a decrease in the content and abolition of cyclic changes in the number of apoptotic cells in the endometrium.

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