The particularly the expression of proliferation markers, angiogenesis of pelvic adhesions in patients with uterine leiomyoma.
Liudmila Kondratovich (RU), Leyla Adamyan (RU), Andrey Kozachenko (RU), Assia Stepanian (RU)
[Kondratovich] Federal Scientific Center for Obstetrics, Gynecology and Perinatology., Moscow, Russian Federation, [Adamyan] Federal Scientific Center for Obstetrics, Gynecology and Perinatology., Moscow, Russian Federation, [Kozachenko] Federal Scientific Center for Obstetrics, Gynecology and Perinatology., Moscow, Russian Federation, [Stepanian] Federal Scientific Center for Obstetrics, Gynecology and Perinatology., Moscow, Russian Federation
Context: uterine fibroids lidiruyusche takes place in the structure of gynecological surgery, requiring surgical treatment .The frequency of adhesions in the abdominal cavity after gynecological operatitsy reaches 90%. Objective: To study the clinical and morphological manifestations, molecular mechanisms of the formation of adhesions in patients with uterine fibroids. Methods: clinical, laboratory, morphological methods. Sampling of biological material: 31 specimens of pelvic adhesions and 12 samples of intact pelvic peritoneum, total of 43 sample. Traditional morphological and immunohistochemical (IHC) studies were performed.Patients: 110 patients underwent laparoscopic myomectomy. 1st group – with peritoneal adhesion n = 34, 2nd group – without peritoneal adhesion, n=76.Results: Morphological study of received samples of adhesion fibers found that in comparison with intact peritoneum adhesive tissue carries 50% more inflammatory and reactive changes of the mesothelium, 56.2% higher number of fibroblasts synthesized, and 50% increase in neovascularisation. IHC examination revealed increasing proliferation marker Ki-67, marker of angiogenesis, markers of matrix metalloproteinases in adhesions fiber compared with the intact peritoneum. The third type collagen, with an unstable, changing structure, dominate in the adhesions tissue. Conclusions. We detected that the «Mature Adhesions» are characterized by pronounced activity of fibroblasts, increased angiogenesis, enhanced response of the mesothelium and the presence of adipocytes. The presence of degenerative changes and increased number of "growth foci" in leiomyoma correlate with an increased risk of adhesion formation in patients with uterine leiomyomata. Correlation between the histologic type of uterine fibroids and the activity of adhesive process is found.