THE STUDY OF IMMUNOHISTOCHEMICAL EXPRESSION OF CERTAIN PRO- AND ANTIAPOPTOTHIC FACTORS IN ENDOMETRY OF PATIENTS WITH ADENOMIOSIS

Objective: to study the immunohistochemical expression of proand anti-apoptotic factors — FasL(CD95), TNF-a, p65 NFkB, and granzyme B in the endometrium of patients with adenomyosis. Material and Methods. The endometrial samples, taken during the proliferative phase of the cycle, while carrying out paypel biopsy and hysteroscopy in 41 women aged 37 to 48 years with adenomyosis. The comparison group consisted of 25 women with infertility. The study of TNF-a, Granzym B, NFkB immunohistochemical expression in the development and progression of adenomyosis was performed using monoclonal antibodies. The results of reaction were evaluated by semiquantitative method. Statistical analysis was performed using the software package Biostat Apps MicrosoftR Excel full-featured office Microsoft Office 2010 package. Results. In the comparison group, the expression of TNF-a and NFkB in endometrium was not evident. In the group of patients with adenomyosis, a marked expression of these markers in epithelial and stromal cells was observed. Granzym B expression was detected in the cytoplasm of leucocytes of the stroma of the endometrial functional layer with no statistically significant differences between the groups. Conclusion. Presumably, given the expression peaks of both TNF-a, p65 NFkB, the observed in adenomyosis increase (compared to normal) in expression of these molecules does not mean readiness of epithelial cells of the endometrial functional layer to apoptosis, as is the norm, upon the occurrence of menstruation, but it means readiness of these cells to proliferate. The absence of statistically significant differences in the number of CD56-positive endometrial stromal granulocytes and endometrial NK-cells, determined by Granzym B expression in these cells, is also an indirect evidence of a low level of readiness to apoptosis. And statistically significantly less expression of FasL(CD95) in women with adenomyosis. That is, TNF-a and NFkB at adenomyosis, probably, play the role of cell survival factors.

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