Modern aspects of the etiology and pathogenesis of hyperplastic endometrial processes

The article presents modern approaches to the etiology, classification and pathogenesis of endometrial hyperplastic processes. Hyperplastic processes of the endometrium, representing an urgent medical and social problem, which is due to the peculiarities of the clinical manifestation of the disease (uterine bleeding), reduced reproductive potential, high recurrence rate, limited conservative treatment of this pathology in pre- and postmenopausal women, due to concomitant extragenital diseases and a high risk of malignancy.On the basis of new criteria of pathomorphological diagnostics, drawing parallels with the accumulated experience and clinical data, the immunohistochemical profile for each histotype of hyperplastic process of endometrium is created, certain diagnostic determinants are defined. Namely, simple and complex endometrial hyperplasia without atypia are characterized by imbalance between proliferation and apoptosis, manifested in moderate activation of the intratissue APUD system, lack of activation of proapoptotic protein p53, increased levels of antiapoptotic protein 2. Atypical forms of endometrial hyperplasia (simple and complex) are characterized by expression in the epithelial component of the proapoptotic protein p53, an increase in the level of antiapoptotic protein Bcl-2 in 2-2.5 times, expressed by activation of the intratissue APUD system.