Evaluation of the impact of developing and maintaining hormone therapy on the cervix uteri of adolescent girls with primary estrogen deficiency
Objective. To evaluate the colposcopic, cytological, and immunocytochemical features of the cervix uteri in adolescent girls who have had no sexual intercourses, have primary estrogen deficiency, and have therapeutically taken a drug containing 17-β-estradiol and dydrogesterone in the time-sequential mode.Kumykova Z.Kh., Uvarova E.V., Batyrova Z.K., Khashchenko E.P., Ezhova L.S., Faizulina N.M., Minaeva E.A.
Subjects and methods. A comprehensive survey was conducted among 48 sexually inactive adolescent girls aged 15-18 years. Among them, 24 adolescents had primary estrogen deficiency, who were therapeutically given a two-phase estrogen-gestagen drug for developing and maintaining hormone therapy (DMHT) and 24 more healthy girls who formed a control group for colposcopy and cytology. Before and within 9 months of treatment, the cervix uteri was evaluated by the results of extended colposcopy, cytological and immunocytochemical examinations of impression smears from the exo- and endocervix. The expression of estrogen receptor-α (ER-α), progesterone receptor A and B, epidermal growth factor, Ki-67, TNF-α, and Cas (LabVision, R&D Systems, and Novocastra Lab Ltd.) was targetedly analyzed.
Results. The use of 17β-estradiol as part of 9-month DMHT contributes to a three-fold increase in the expression of ER-α and in the moderate activation of proliferation processes with unchanged apoptosis, which manifests itself as restoration of maturity of the cervical and vaginal epithelium and as normalization of vaginal microbiocenosis.
Conclusion. The found changes suggest that the combination drug containing 17β-estradiol and dydrogesterone has a positive effect on the vaginal epithelium and cervix uteri in adolescent girls with primary estrogen deficiency.
Keywords
adolescent girls
cervix uteri
primary estrogen deficiency
developing and maintaining hormone therapy
Supplementary Materials
- Fig. 1. Acetobescular epithelium, mosaic, puncture, iodnegative zone
- Fig. 2. Cervical Ectopy
- Fig. 3. Ectopia with normal zone of transformation
- Fig. 4. Stratified squamous epithelium
- Fig. 5. Results of advanced colposcopy in patients before and after 9 months of developing and maintenance hormone therapy
- Fig. 6. Dynamics of ER, EGF, TNF-α and Cas expression in endocervix before therapy and after 9 months of developing and maintenance hormone therapy
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Received 09.06.2017
Accepted 23.06.2017
About the Authors
Kumykova Zaira Khasanovna, MD, Ph.D., 2nd gynecological department (gynecology of children and adolescents), Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: zai-kumykova@yandex.ruUvarova Elena Vitalevna, MD, professor, head of the 2nd gynecological department (gynecology of children and adolescents), Research Center of Obstetrics, Gynecology,
and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: elena-uvarova@yandex.ru
Batyrova Zalina Kimovna, Ph.D., scientific employee of the 2nd gynecological department (gynecology of children and adolescents), Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: linadoctor@mail.ru
Khashchenko Elena Petrovna, Researcher of the 2nd gynecological department (gynecology of children and adolescents), Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: khashchenko_elena@mail.ru
Ezhova Larisa Sergeevna, Candidate of Medical Sciences, Senior Researcher, 1st pathoanatomical department, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: l_ezhova@oparina4.ru
Fayzullina Nafisa Munavarovna, Ph.D., Ph.D., 1st pathoanatomical department, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: n_faizullina@oparina4.ru
Minaeva Ekaterina Alekseevna, a student of the 6th year of pediatric faculty of N.I. Pirogov RNIMU. E-mail: minaevakatya93@yandex.ru
For citations: Kumykova Z.Kh., Uvarova E.V., Batyrova Z.K., Khashchenko E.P., Ezhova L.S., Faizulina N.M., Minaeva E.A. Evaluation of the impact of developing and maintaining hormone therapy on the cervix uteri of adolescent girls with primary estrogen deficiency.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (3): 116-21. (in Russian)
https://dx.doi.org/10.18565/aig.2018.3.116-121
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