Вісник проблем біології і медицини (Dec 2020)
PATHOHISTOLOGICAL AND IMMUNOHISTOCHEMICAL FEATURES OF THE ENDOMETRIUM IN CHRONIC ENDOMETRITIS IN WOMEN WITH INFERTILITY (LITERATURE REVIEW)
Abstract
In the analysis of modern scientific literature data, an actual view of the problem of infertility in women is presented. The issues of infertility continue to remain relevant and the status of the highest priority areas in obstetrics and gynecology due to the consistently high frequency in the world population and significant prevalence. The leading place among the causes of the uterine factor of infertility is chronic endometritis. This disease means a clinical and morphological syndrome, which is often initiated by an infectious agent, develops as a result of a selfsustaining inflammatory process, which is based on a violation of the production of pro-inflammatory cytokines, is characterized by the development of persistent anatomical and functional changes in the glandular epithelium of the uterus with disruption of normal cyclic transformation and tissue receptivity. Histopathological examination should be considered the fundamental method of its verification as the most important factor of uterine infertility, as well as a method of monitoring the success of its drug therapy. However, classical morphological methods for diagnosing chronic endometritis are imperfect and do not allow determining the etiology, nature of the process, and fully assessing the features of the immune response and hormonal status. Most researchers believe that optimization of diagnostics and control quality of therapy for chronic endometritis are possible using the immunohistochemical method. In the study of endometrial dysfunction in chronic endometritis, it is advisable to include markers of immunocompetent cells CD3, CD4, CD8, CD20, CD138, CD56, CD68; markers of estrogen and progesterone (ER and PR), proliferation marker Ki-67, endometrial stem cell marker CD44, vascular endothelial factors CD34 and VEGF, p16 and EBV protein as indicators of infection with human papillomavirus and Epstein-Barr virus, antiapoptotic protein Bcl-2. Such a broad panel of markers will help improve the diagnosis and treatment efficacy of chronic endometritis in women with infertility.
Keywords