Introduction/Background Chronic metroendometritis is responsible for 75% of cases of uterine disorders in women of the reproductive age, such as adenomyosis, uterine fibroids or endometrial polyps. Infection is considered a promoter of polyposis and endometrial carcinoma (EC) in postmenopausal patients. Our purpose was to determine the influence of chronic infection on the formation of clinical and morphological variants of EC.
Methodology Postoperative data on morphological and microbiological examination of EC tissues of 240 patients (mean age 64.5 years, 27% - reproductive age, 73% - peri- and menopausal patients) were studied. After removal of the preparation, the macroscopic state of tumors was evaluated intraoperatively together with the morphologist, and tumor tissues were collected for microbiological examination. The presence of bacterial or viral infections in EC tissues was detected by PCR and ELISA.
Results EC tissues were morphologically studied with detailed characteristics of the tumor process. 87% - endometrioid EC, 13% - aggressive variants (papillary serous carcinoma and adenosquamous carcinoma). 62% of EC were infected with chlamydia, cytomegalovirus, herpes simplex viruses and HPV. Tumors in patients of reproductive age were infected in 92%. 54% of adenosquamous tumors were infected with HPV 18. Endometrioid tumors showed combined bacterial and viral infections in 83%, monoinfection (bacterial or viral) in 16%; combined viral infections were rare. Patients of reproductive age with monoinfections had the most favorable variants of G1-2 EC in 43% of cases. Older menopausal patients with tumors infected with viral agents demonstrated atrophic endometrium and aggressive G2-3 EC.
Conclusion The presence of chonic infection in EC is directly associated with the morphological type and aggressiveness of tumors and the patient's age.
Disclosure Nothing to disclose.
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