Международный эндокринологический журнал 3 (67) 2015

Endometrial cancer ranks 7th leading cause of death from malignancies in Europe, including in Ukraine, and is 1-2% of all deaths due to cancer. In 20% of cases of endometrial carcinoma diagnosed childbearing age, and a tendency to increase in incidence during this period continued to increase.

Various risk factors histopathological variants and molecular mechanisms of tumor development leading to two pathogenic variants of endometrial cancer. First pathogenic variant is hormone, mainly tumor endometrioid type of structure (against obesity, infertility, late menopause, diabetes, uncontrolled long-term impact of hormones containing estrogen). Second pathogenic variant (аutonomous), for it is not a characteristic of endometrioid tumors. Both are characterized by different molecular genetic disorders. One is the RER+ (replication error) phenotype, also called microsatellite instability (MSI), reflecting defect repair unpaired DNA bases. Research in the field of molecular biology, pathogenesis of endometrial carcinomas are not yet fully understood, indicating the possibility of using the MSI to assess progress, prognosis and treatment of this disease features. The purpose of our study was to examine the morphological features of uterine malignancies in patients with MSI.

The material for the study is based on observations mainly endometrial cancer stage I-II in patients who underwent radical surgery in Kharkiv Regional Clinical Cancer Center. To identify the MSI in all patients in the tumor tissue was used method of polymerase chain reaction. To study the morphological features of endometrial cancer we conducted histological promptly deleted uterine tumors in 342 patients. Fragments excised tumors were fixed in 10% formalin solution and embedded zabuferovanoho in paraffin. From the prepared paraffin blocks were made serial sections of 3-4 mm thick, which were placed on glass slides subject to standard hematoxylin and eosin staining and immunohistochemical adhesive slides for study.

Immunohistochemical method was found in tumor cells the expression of estrogen receptor, progesterone proliferative activity marker Ki-67 (Mib-1), a marker of apoptosis bcl-2 (124) using primary monoclonal antibodies, Rady-to- Use and detection system LSAB -2 System, HRP + DAB, firm DAKO (Denmark). The complex morphological and morphometric studies conducted on microscope Primo Star (Carl Zeiss) using programs AxioCam (ERc 5s) and Microsoft Excel.

Studies have shown that the morphological features of tumors had significant differences depending on the presence or absence of MSI in tumor tissue. The vast amount of MSI+ carcinomas related to the group endometrioid tumors, and most often manifested in MSI of low endometrioid cancers. 3/4 MSI+ positive tumors had status and progesterone receptors were found us more than to estrogen receptors. Most progesterone-positive tumors was found in the group G1, and with MSI+ carcinomas were 90.0%. Most of estrogen-positive adenocarcinoma of the degree of tumor differentiation were mostly MSI- G1 tumors (80.0%). The value of the index proliferative activity, manifested us using to the Ki-67 (MIB-1) monoclonal antibodies, endometrioid cancers is increasing with a decrease in the degree of differentiation of carcinomas, and was generally higher in MSI+ tumors. Endometrioid carcinomas not form on our material had a negative receptor status and showed higher proliferative activity in MSI+ tumors. The frequency of bcl-2-positive tumor MSI+ has always been higher than the frequency of bcl-2 negative MSI- in endometrial tissue and in ways not endometrioid endometrial cancer