Poliakova Y. Optimization of diagnosis and treatment of hyperplastic conditions of the endometrium in metabolic syndrome

Українська версія

Thesis for the degree of Doctor of Philosophy (PhD)

State registration number

0823U101694

Thesis Registration Form

0823U101694.pdf

Applicant for

Specialization

  • 222 - Медицина

Specialized Academic Board

СВР 31_3470

Kharkiv National Medical University

Essay

The active integration of modern technologies into the practical work of Ukrainian gynecologists, the development or implementation of global quality standards for examination and treatment, and the provision by the state of ultrasound diagnostic equipment and hysteroscopes to almost all medical institutions, along with the provision of a free package of services for the early detection and treatment of uterine cancer, have not yet led to a decrease in the number of cases. Uterine cancer still holds a leading position both in Ukraine and globally. The obvious mismatch between financial efforts and the end result is apparent. Therefore, the crucial aspect today is the categorization of organic changes in the uterus into precancerous conditions and background hyperplastic processes. This involves defining criteria for categorizing patients into those who only need screening examinations and those who require costly in-depth examinations. It also involves determining the prevalence of diseases that pose a high risk of oncopathology, assessing the accuracy of routine research methods, and exploring the possibility of using organ-preserving treatment methods. In essence, everything that allows optimizing the treatment of endometrial hyperplastic conditions and thereby reducing the incidence of uterine cancer, providing the opportunity for early detection, and expanding the "survival window." This was the focus of the conducted research. The research determined the prevalence of metabolic syndrome among patients with endometrial pathology and identified changes in the prevalence of different types of endometrial hyperplastic conditions. A comparative analysis of the diagnostic accuracy of endometrial hyperplastic processes was conducted based on the type of pathology and the presence or absence of metabolic syndrome. The sensitivity and specificity of transvaginal ultrasound diagnosis of endometrial hyperplastic processes were determined through pathological histological verification. The study also explored the psychological state of women with different types of endometrial hyperplastic processes and metabolic syndrome. The morphological justification for the precise timing of diagnostic procedures (hysteroscopy, pipelle biopsies, diagnostic curettage) depending on the menstrual cycle phase in cases of suspected endometrial hyperplasia was investigated. A significant number of inconclusive results (such as "gray areas") were identified when obtaining biopsies in an inappropriate cycle phase, preventing accurate diagnosis and requiring additional invasive and costly interventions. The need for establishing new criteria for the timing of obtaining biopsies for different types of endometrial pathology was demonstrated. Morphological characteristics of endometrial changes in conditions of metabolic disorders, specifically metabolic syndrome, were obtained. Signs of microsatellite instability in the endometrium of women with endometrial hyperplastic conditions and metabolic syndrome were studied, justifying the possibility of identifying preclinical signs of mutational changes and predicting the progression of atypical endometrial hyperplasia leading to endometrial cancer. The patient-oriented approach to diagnostic and therapeutic measures in patients with endometrial hyperplastic processes was improved. This approach involves determining markers of microsatellite instability in the presence of metabolic syndrome or specific metabolic disorders as risk factors for endometrial cancer. It also includes obtaining biopsies when suspecting endometrial hyperplasia only in the second phase of the menstrual cycle, assessing the presence and degree of depression, and quality of life during screening for endometrial pathology.

Read more

Research papers

1. Poliakova Y., Lutsenko N. Diagnostic Accuracy of Transvaginal Sonography in the Detection of Endometrial Polyps : Journal of Diagnostic Medical Sonography. 2020. Vol. 36. P. 31–35.

2. Poliakova Y., Lutsenko N., Haidai N. Diagnosis of endometrial hyperplasia in routine gynecological practice : Zaporozhye Medical Journal. 2019. Vol. 21. P. 95–99.

3. Щербина М. О., Полякова Є. М., Луценко Н. С. Діагностична цінність трансвагінальної ультразвукової діагностики поліпів ендометрія : Збірник наукових праць Асоціації акушерів-гінекологів України. 2020. № 46. С. 76–81.

4. Полякова Є. М, Щербина М. О. Морфологічні перетворення ендометрія в контексті нових класифікаційних критеріїв. Перспективи та інновації науки. 2023. № 31. С. 783–790.

5. Щербина М. О., Полякова Є. М. Психологічний стан у жінок з гіперпроліферативними процесами ендометрія та метаболічним синдромом. Перспективи та інновації науки. 2023. № 30. С. 1092–1103.

6. Полякова Є. М. Поліпи ендометрія: огляд сучасних даних. Слово про здоров’я. 2019. № 21. С. 22–26.

7. Полякова Є. М. Гіперплазія ендометрія. Огляд сучасних даних. Слово про здоров’я. 2019. № 20. С. 40–46.

8. Полякова Є. М. Психологічний стан у жінок з гіперпроліферативними процесами ендометрія та метаболічним синдромом. Future of Work: Technological, Generational and Social Shifts. Proceedings of the 2nd International Scientific and Practical Internet Conference. Дніпро, Україна, 2023. Р. 144–145.

9. Poliakova Y. Psychological status in women with hyperproliferative processes of the endometrium and metabolic syndrome. War – Challenges in Modern Science. Abstracts of the 51st International scientific and practical conference, Littera Verlag, Berlin : 2023. Р. 79–81.

10. Poliakova Y., Karnaukh A., Tolok O., Kanaki A. A patient-centered strategy for diagnosing and managing hyperplastic endometrial conditions in individuals with metabolic syndrome through molecular-genetic oncogenomic markers. European scientific congress. Proceedings of the 7th International scientific and practical conference. Madrid, Spain : Barca Academy Publishing, 2023. Р. 22–24.

11. Poliakova Y., Karnaukh A., Tolok O. Patient-oriented approach to the diagnosis and treatment of hyperplastic processes of the endometrium in patients with metabolic syndrome based on the determination of molecular-genetic markers of certain links in oncogenomics. Science and technology: problems, prospects and innovations. Proceedings of the 11th International scientific and practical conference. Osaka, Japan : CPN Publishing Group, 2023. Р. 30–36.

12. Poliakova Y., Sorokina I. Gray zone as a morphological criterion of endometrial status. Justification of conditions for precise diagnosis in screening determination of endometrial hyperplasia. Current challenges of science and education. Berlin : MDPC Publishing, 2023. Р. 32–33.

13. Poliakova Y, Karnaukh A. Morphological analysis of the endometrial condition in women experiencing hyperplasia with metabolic syndrome. Modern research in science and education. Chicago : BoScience Publisher, 2023. Р. 33–36.

14. Полякова Є. М. Особливості психологічного стану у жінок з гіперпроліферативними процесами ендометрія та метаболічним синдромом. «Травневі наукові зібрання-2023» : збірник наукових матеріалів СXXIV міжнародної науково-практичної інтернет-конференції. Івано-Франківськ, 2023. С. 131–134.

15. Полякова ЄМ. Аналіз клінічних спостережень діагностики та лікування гіперпластичних станів ендометрію при метаболічному синдромі . Achievements of 21st Century Scientific Community: Proceedings of the 1st International Scientific and Practical Internet Conference, Дніпро: FOP Marenichenko V.V; 2023, p. 364.

16. Полякова ЄМ. Підхід, орієнтований для пацієнта, для діагностування та лікування гіперпластичних змін ендометрія у жінок із метаболічним синдромом на основі виявлення молекулярно-генетичних показників в різних етапах онкогеноміки. Scientific research in the modern world. Proceedings of the 12th International scientific and practical conference, Toronto: Perfect Publishing; 2023, p. 204–8.

Read more

Files

Poliakova_dys.pdf

autoreferat-Poliakova_an.pdf

editrequest-Poliakova_pov.pdf

Similar theses

0824U001377

Yurii D. Ukhach

ANESTHETIC SUPPORT FOR PATIENTS WITH GUNSHOT WOUNDS OF THE HEAD DURING AIROMEDICAL EVACUATION

0824U001364

Zurab Gatserelia

Partial cystectomy with chemoradiation therapy for muscle-invasive bladder cancer

0824U001366

Iryna M. Ivanchuk

Structural and functional changes of the cerebral cortex in terms of experimental oncogenesis and under conditions of nanomaterials correction application

0824U001367

Olesia S. Redko

Morphofunctional state of the liver during acute respiratory distress syndrome and its treatment by mesenchymal stem cells

0824U001350

Olena O. Kolomiiets

Pathomorphological characteristics and optimization of diagnosis and prognosis of invasive ductal breast cancer with biomineralization