Butakova M. Optimization of complex treatment of reproductive age women with benign epithelial ovarian tumors of non-endometrial ori

The dissertation work presents a new solution to the actual problem of modern gynecology – an increase in the number of cases of onset and gestation of pregnancy in women with organ-sparing treatment of benign epithelial ovarian tumors of non-endometrioid origin. The data on the role of clinical and anamnestic parameters, determination of tumor-associated tumor markers, spectral Doppler ultrasonography, magnetic resonance imaging with contrast enhancement and morphological express study of frozen tumor biopsy sections in order to exclude malignancy of the formations before surgical treatment have been supplemented. It has been shown that in benign epithelial ovarian tumors of non-endometrioid origin, hormonal dysregulation is observed both at the level of gonadotropic and steroid hormones, the accumulation of free radical oxidation products, dysregulation of the enzyme system of the glutathione system with a decrease in the levels of reduced glutathione, and a decrease in the activity of enzymatic and non-enzymatic antioxidants. to the development of endogenous intoxication with a significant increase in the concentration of average weight molecules in the blood. It was found that benign epithelial cystadenomas occur against the background of nitrosative dysregulation with a decrease in the content of serum L-arginine and neutral metabolites in the blood and, with different genesis, differ in intracystic NOx concentrations. Based on the immunohistochemical study of the expression of Ki-67, lectin receptors, NO expression, and iNOS activity, new data on the features of hyperproliferation processes in benign epithelial ovarian tumors were obtained. It was shown for the first time that the use of the developed method of complex treatment of benign epithelial ovarian tumors in women of reproductive age leads, compared to women with traditional treatment, to a significant decrease in the activity of indicators of free radical oxidation and peroxide hemolysis of erythrocytes, an increase in the activity of enzymatic and non-enzymatic antioxidants, levels of L-arginine and neutral NO metabolites, a decrease in endogenous intoxication, as a result of which the number of cases of pregnancy and childbirth in serous cystadenomas increases by 1.57 (p<0.04) and 2.00 (p<0.01) times, respectively, with mucinous cystadenomas – in 1.67 (p<0.04) and 2.11 (p<0.01) times.