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Lysenko O.V.
Adenocarcinoma and endometrial polyps in postmenopausal women: cytokines balance, sFas-ligand secretion and antirelapse therapy

Objectives. To explore the secretion of cytokines and sFas-ligand at the local and systemic levels in adenocarcinoma and endometrial polyps at the postmenopausal age and to suggest a new scheme of antirelapse therapy based on these changes.
Material and methods. We have observed 92 female patients: 46 postmenopausal women with glandular-fibrous endometrial polyps constituted the first main group; 13 postmenopausal female patients with endometrial adenocarcinoma made up the second main group; 33 postmenopausal women with endometrial atrophy belonged to the control group.  Aspirates from the uterine cavity have been taken to determine the concentrations of interleukin-2, interleukin-4, tumor necrosis factor-alpha, interleukin-1n, interleukin-6, interleukin-8, interleukin-10, interferon-, and sFas-ligand. We have used aspiration probes «Yunona» (Vitebsk – St. Petersburg). The concentrations of cytokines and sFas-ligand have been determined in the blood serum of the examined patients as well. Aspirates have also been taken in 6 months.
Results. We have found that the concentration of cytokines and sFas-ligand at the local level was significantly higher in comparison with blood serum. The content of cytokines and sFas-ligand in blood serum did not differ significantly both in endometrial polyps and adenocarcinoma, and in the norm. At postmenopausal age in endometrial polyps and adenocarcinoma we observed an imbalance of the local secretion of pro- and anti-inflammatory cytokines, changes of endometrial cells ability to Fas-indirect apoptosis. Antirelapse treatment of endometrial polyps with complement to traditional therapy of human recombinant interleikin-2 leads to the normalization of the local cytokine imbalance and may be the optimal scheme of  therapy.
Key words: polyp, adenocarcinoma, endometrium, cytokines, sFas-ligand, therapy.


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