State of microbiogenesis of the endometrium in women with hyperplastic processes and chronic endometritis according to PCR test
DOI:
https://doi.org/10.15574/HW.2022.160.4Keywords:
hyperproliferative endometritis, chronic endometritis, polymerase chain reactionAbstract
Purpose - to study the status of endometrial microbiocenosis in women with hyperplasia of endometrium (HE) and to evaluate the influence of the inflammatory process in the pathogenesis of hyperplasia.
Materials and methods. There were studied 161 women, of whom group 1 consisted of 58 women with HE without an inflammatory process, group 2 consisted of 71 women with a combination of HE and chronic endometritis - CE. The group 3 (control) consisted of 32 women in whom no pathological changes were found during diagnostic scraping. In all women detection of the genome of possible inflammatory process pathogens was carried out using the polymerase chain reaction (PCR).
Results. According to the PCR test, the levels of staphylococcus, streptococcus, and corynebacteria were the highest in the group 3 (68.8%, 21.9%, and 50.0%, respectively), and were lower in the group 1 (46.6%, 6.9% and 24.1%, respectively), and even smaller in group 2 (31.0%, 9.9%, 12.7%, respectively). The resident microbiocenosis of the large intestine - Enterococcus faecalis - was found in the endometrium of representatives of all studied groups. Herpes virus was detected in 31.0% of women with group 1, 26.8% of women with group 2 versus 12.5% of group 3 respondents (p<0.05). Cytomegalovirus was detected in 12.1%, 11.3% vs. 3.1%, respectively (p<0.05), and papilloma virus - in 24.1% and 26.8% vs. 6.3%. The high level of associated pathogenic microflora is noteworthy, especially in the group 2, where it is 66.2%, which is significantly higher than the indicator of the group 1 (39.6%, p<0.05), and significantly higher than the group 3 indicators (9.4% p<0.001). In the group 3, tests with a low titer of enterobacteria prevail (103-104) - 97.1%, which is significantly more than in the group 1 (10.3%) and women group 2 (0%), p<0.001. In the group 1, the highest mean titer was 104-105 (89.7%), which was significantly higher than the group 2 (2.9%) and the group 3 (9.4%), p<0.001. In the group 2, the highest rate of high titer according to PCR data (>106) was 97.1%, which significantly exceeds the zero rates in both other groups.
Conclusions. In the group of women with a combination of hyperplastic and inflammatory processes, we observed a significant increase in associated infectious agents, both microorganisms and viruses. One hundred percent presence of enterobacteria among female respondents of all groups is noteworthy. The detection of representatives of the intestinal microbiota in the endometrium indicates the probable role of dysbiotic disorders of the gastrointestinal tract. In our opinion, the titer of enterobacteria according to the PCR test can be a marker of the inflammatory process and a diagnostic criterion for choosing a treatment method.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Agorastos T. (2015). Treatment of endometrial hyperplasias. Gynecol Oncol. 3 (65): 102-114. https://doi.org/10.1006/gyno.1997.4639; PMid:9103399
Boichuk AV, Shadrina VS, Vereshchahina TV. (2019). Hiperplaziia endometriia - suchasnyi systemno-patohenetychnyi pohliad na problemu (ohliad literatury). Aktualni pytannia pediatrii, akusherstva ta hinekolohii. 1: 67-72. https://doi.org/10.11603/24116-4944.2019.1.9906
Brunham RC, Gottlieb SL, Paavonen J. (2015). Pelvic inflammatory disease. N Engl J Med. 372 (21): 2039-2048. https://doi.org/10.1056/NEJMra1411426; PMid:25992748
Chaika HV, Yaremchuk LV, Karetna AO. (2017). Optymizatsiia likuvannia ta reabilitatsii reproduktyvnoi funktsii zhinok z hiperplaziieiu endometriia na tli zapalnykh zakhvoriuvan orhaniv maloho tazu. Visnyk Vinnytskoho natsi onalnoho medychnoho universytetu. 1 (21): 302-306.
Donska YuV, Loskutova TO, Simonova NV, Petulko AP. (2018). Optymizatsiia likuvannia zhinok z khronichnym endometrytom yak rezerv pidvyshchennia fertylnosti. World Science. 10 (38): 28-32.
Fortner RT, Terry KL, Bender N et al. (2019). Sexually transmitted infections and risk of epithelial ovarian cancer: results from the Nurses' Health Studies. Br J Cancer. 120: 855-860. https://doi.org/10.1038/s41416-019-0422-9; PMid:30894687 PMCid:PMC6474309
Grigoriev E, Sytnik P, Dyakov A, Sytnik O. (2020). Analysis of the microbial spectrum in women with purulent-inflammatory diseases of the pelvic organs in the context of the provision of urgent surgical gynecological care, taking into account risk factors. Health of Woman. 3 (149): 38-41. https://doi.org/10.15574/HW.2020.149.38
Haggerty CL, Totten PA, Tang G, Astete SG et al. (2016). Identification of novel microbes associated with pelvic inflammatory disease and infertility. Sex Transmit Infect. 92: 441-446. https://doi.org/10.1136/sextrans-2015-052285; PMid:26825087 PMCid:PMC5013099
Hryhorenko AM. (2017). Hiperplaziia endometriiu: zapytan bilshe, nizh vidpovidei. Zhinochyi likar. 6: 17-21.
Ingerslev K, Hogdall E, Schnack TH, Skovrider-Ruminski W, Hogdall C, Blaakaer J. (2017). The potential role of infectious agents and pelvic inflammatory disease in ovarian carcinogenesis. Infect Agents Cancer. 12: 25. https://doi.org/10.1186/s13027-017-0134-9; PMid:28529540 PMCid:PMC5437405
Kitaya K, Takeuchi T, Mizuta S, Matsubayashi H, Ishikawa T. (2018). Endometritis: new time, new concepts. Fertility and Sterility. 110 (3): 344-350. https://doi.org/10.1016/j.fertnstert.2018.04.012; PMid:29960704
Podolskyi VlV, Podolskyi VV. (2017). Modern options of outpatient treatment of chronic inflammatory diseases in fertile aged women caused. Health of Woman. 5 (121): 132-136. https://doi.org/10.15574/HW.2017.121.132
Sadigov YuM. (2018). Role of an infectious pathogen in development of hyperplastic processes of uterus. Health of Woman. 2 (128): 53-55. https://doi.org/10.15574/HW.2018.128.53
Sfakianoudis K, Simopoulou M, Nitsos N, Lazaros L, Rapani A, Pantou A et al. (2019). Successful implantation and live birth following autologous platelet-rich plasma treatment for a patient with recurrent implantation failure and chronic endometritis. In Vivo. 33: 515-521. https://doi.org/10.21873/invivo.11504; PMid:30804135 PMCid:PMC6506282
Snopkova LV, Cherepova VI, Kandyba LI, Sykal IM. (2019). Suchasni mozhlyvosti diahnostyky khronichnoho endometrytu. Problemy bezperervnoi medychnoi osvity ta nauky. 3 (35): 68-72. https://doi.org/10.31071/promedosvity2019.03.068
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