Kravchenko Y. Endometrial hyperplastic processes recurrence’ prediction and prevention among women of reproductive age

The relevance of the problem of hyperplastic processes of the endometrium is due to the high prevalence of the disease (from 14 to 83%), especially among women of reproductive age, the frequent need for hospitalization (10-18%) due to abnormal uterine bleeding, the tendency to relapse and the risk of malignancy. Since endometrial hyperplasia is a hormone-dependent disease, the largest proportion of patients are women of childbearing age (up to 85% of cases), which undoubtedly reduces reproductive potential and is one of the causes of impaired fertility. The main clinical manifestation of hyperplastic processes of the endometrium remains abnormal uterine bleeding, which often leads to hysterectomy, which in turn makes it impossible to implement the reproductive function, leads to the invalidation of a woman and a decrease in her quality of life. Interest in this pathology is also due to the propensity for a long relapsing course, the difficulty of differential diagnosis, the difficulties of individual selection of treatment depending on the age group. Late diagnosis and treatment of endometrial hyperplasia can cause malignant transformation of cells, which is especially worrying considering the steady increase in the incidence and rejuvenation of endometrial cancer. Despite numerous interdisciplinary studies, to date there are no clear models for predicting the course of the hyperplastic process, which leads to the search for new immunohistochemical methods of endometrial biopsy research with the aim of increasing the accuracy of diagnosis, effective forecasting and adequate selection of treatment tactics. The aim of the research has been to improve the results of treatment of patients of reproductive age with endometrial hyperplasia by studying new pathogenetic mechanisms of the development and recurrence of this pathology, implementing a differentiated pathogenetically based treatment algorithm.