4 курс / Акушерство и гинекология / Клинико_морфологические_особенности_злокачественной

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Descriptive statistics of quantitative indicators such as age, body mass index, number of pregnancies, births, abortions, proliferative activity index Ki-67, β-catenin and PDL1 were calculated using standard concepts: averages, deviations, percentage composition, medians and quarters.

The analysis of linear variables was carried out using the ANOVA dispersion method. Since all linear variables had an abnormal distribution, their analysis was carried out using the Univariate General Linear Model (UnANOVA) after the variables were ranked (on ranks). The nonparametric Kruskal-Wallis (KW) and Pairwise test was used to compare linear variables between histological groups. The analysis of nominal variables when comparing their frequency distribution according to histological conclusions is presented according to the results of the chi-square/χ2 or Fisher's Exact test response tests.

The criterion of statistical reliability of the obtained conclusions was considered to be the generally accepted value in medicine p<0.05. In cases where the test (ChiSq or Fisher) showed significant differences (p<0.05) between groups, calculations of odds ratio, relative risk, sensitivity and specificity (Odd ration – OR, Relative Risk – RR, Sensitivity, Specificity) were added for IHC indicators. Binomial logistic regressions were constructed using the Forward Stepwise (Conditional) method.

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A g e

Figure 4 – Age distribution of patients

with hyperplastic processes and endometrial adenocarcinoma

The age of patients with benign EH is less than that of patients with AEH (p<0.001) and EC (p<0.001), while the age of patients in the AEH group is less than the EC group (p=0.002).

The incidence of various pathologies of the endometrium differed between the periods of aging of the female reproductive system (p<0.001): EH was more common in women in the reproductive period compared to AEH and EC, which were more common in postmenopausal women. AEH was more common in the reproductive and transitional periods compared to EC, which was more common in postmenopausal women (Figure 5).

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a number of reasons: unavailability of histological material, insufficiency or inadequacy of the material after the manufacture of multiblocks, other histological types of endometrial cancer (serous adenocarcinoma, clear cell adenocarcinoma) and other changes in the endometrium (impaired proliferation of the endometrium, secretory endometrium, mucinous proliferation), which were not the aim of this study.

Clinical and anamnestic characteristics of the groups.

Group 1: patients diagnosed with endometrial hyperplasia without atypia

(EH without atypia)

The group of patients with endometrial hyperplasia without atypia was 35 women. The average age of this group was 46±6 years. 11 (31%) women were reproductive age, 22 (63%) were in transition period, and 2 (6%) were postmenopausal. Most of them had complaints about AUB – 83% (of which 39% were with laboratory-confirmed anemia (hemoglobin below 120 g/l)), the rest did not complain (Table 5). The indication for morphological examination in this case was the data of ultrasonography: the mismatch of the thickness and structure of the endometrium with the phase of the cycle.

Among the risk factors for the development of endometrial hyperplasia and neoplasia in this group, obesity was the most common in 60% of cases and overweight in 26% of cases, and both factors were respectively present in almost all women in 86% of cases. The average BMI was 29±7 kg/m2. The average number of pregnancies is 3±2, of which, on average, 1±1 childbirth and 2±2 abortions. None of the studied women had diabetes. Hypertension occurred in 31% of women, AIT – in 11% (table 5).

Among the reproductive risk factors in 11% of cases (in 4 patients), early onset of menstruation (before 11 years) was noted, in 14% (in 5 patients) infertility was observed (table 5).

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Table 5 continued