Structural and biochemical features of menstrual discharge in patients with uterine fibroids

Objective. To improve the method for diagnosing endometrial pathology in patients with uterine fibroids by identifying structural and biochemical markers of inflammation, proliferation, and apoptosis in the menstrual discharge of the examined patients. Materials and methods. A total of 111 patients were examined, including 40 patients with slow-ly growing uterine myoma (Group 1), 30 patients with rapidly growing uterine myoma (Group 2), and 41 practically healthy women (control group). Patients in all groups were comparable in age. Along with traditional examination methods, all patients underwent a comprehensive study of menstrual discharge. For microscopic analysis of structural features of menstrual discharge, the wedge dehydration method was used. The content of proliferation markers — APRIL and apopto-sis markers — TRAIL were determined using the corresponding test systems by the enzyme im-munoassay, the level of ceruloplasmin — by immunoturbimetric method, and the content of C-reactive protein — by the latex agglutination method. Results. The presented data allow us to consider the use of the wedge dehydration method with simultaneous assessment of the level of acute phase proteins, proliferation and apoptosis indices in the menstrual discharge of patients with uterine myoma as promising for identifying various histotypes of hyperplastic processes in the endometrium formed against the background of chron-ic endometritis. Comparison of the obtained data with the results of traditional methods of exam-ining patients with this pathology allows us to count not only on increasing the effectiveness of early diagnostics of the diseases of endometrium and myometrium, but also on choosing the op-timal treatment plan, objectively assessing its results and thereby preserving the reproductive health of women. Conclusion. The structural and biochemical markers of inflammation, proliferation and apoptosis revealed in menstrual discharge in the considered pathology of the endometrium and myometri-um allow us to consider their identification as a promising method for diagnosing not only in-flammatory processes, but also hyperplastic processes in the endometrium of various histotypes, and also to rely on the choice of optimal treatment tactics, an objective assessment of its effec-tiveness.