Kartashova M. Diagnostics and treatment of endometrium hyperproliferation in patients with microsatellite instability and ESR gen methylathion.

Incidence of epigenetic disorders (methylation) of ESR gene and genome microsatellite instability (MSI) was studied in endometrial tissue and endometrial polyps of 210 female patients. Patients with ESR gene methylation and/or MSI+ phenotype were included to investigated group (73 patients - 44.7 %); patients without mentioned pathology were included to comparison group (137 females - 65.3 %). Mean age of patients in groups was 49.4 ± 3.6 and 47.3 ± 5.3 years, respectively. We have established that patients with endometrial hyperplasia (EH) and infertility, overweight or diabetes mellitus have more frequent microsatellite genome instability and ESR gene methylation in hyperproliferative endometrial cells. Relapse of endometrial hyperplasia and atypia with preexisting hyperproliferation of endometrium significantly correlates with MSI+ phenotype and ESR gene methylation. These processes can be estimated as pathogenetic factors and progression criteria of pathologic process. In EH patients ESR gene methylation and MSI should be taken into account as well as age period in the case of treatment choice. Presence of epigenetic disorders of ESR gene and/or genome microsatellite instability decreases efficacy of hormonal therapy in EH patients with/without atypia and increases risks of relapsing and disease progression. Use of organ preserving treatment methods is not well-reasoned in atypical EH patients