DYNAMIC DETERMINATION OF MACROPHAGE COLONY–STIMULATING FACTOR (CSF–1) IN ENDOMETRIOID DISEASE IN MENSTRUAL BLOOD AT THE PREOPERATIVE STAGE AND AFTER THE FOLLOWING CONSERVATIVE TREATMENT

Orlova Yu. A., Hromova A. M., Shlykova O. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Endometrioid disease (ED) occupies a leading position in the structure of patients admission to gynecological departments, and the prevalence of this disease is 10% among the female population. Today, there is no common point of view regarding the etiological and pathogenetic links of ED, which leads to a limitation, both in the diagnosis and in the treatment of this pathology. The aim of the research. Determine the level of macrophage colony–stimulating factor (CSF–1) in menstrual blood over time before surgery for ED and after surgery followed by conservative therapy. To assess the effectiveness of conservative treatment for ED. The study group (SG) was represented by 50 women with ED. The control group (CG) included 30 women without signs of ED. All the women presented were operated on for benign gynecological pathology. Menstrual blood of women in the study groups was collected in menstrual cups on days 2-3 of menstrual bleeding before surgery (in SG n=43 and CG n=19), in women with SG after only surgery – subgroup B (n=8) and after surgical treatment followed by conservative treatment – subgroup A (n=11). Conservative treatment included generally accepted protocol schemes. Determination of the concentration of CSF–1 in menstrual blood was carried out by enzyme-like immunosorbent assay. Results. Average level of CSF–1 values were 9431.6±2866.22 pg ml in SG and 6637.12±954.05 pg/ml in CG. These indicators significantly statistically differed, namely, 1.4 times more (p=0.00004) in the presence of ED. The average level of CSF–1 in women of subgroup B was 12290.85±2294.35 pg/ml, and in women of subgroup A – 8761.02±2816.4 pg/ml. It was found that the level of CSF–1 in women of subgroup B was 1.4 times higher (p=0.02). It was found that women of subgroup B had a level of CSF–1 1.3 times higher than women in SG before surgery. There was no significant difference between the level of CSF–1 in SG women before surgery and in women of subgroup A (9431.6±2866.22 pg/ml versus 8761.02±2816.4 pg/ml, respectively; p=0.54), however, there is a tendency towards a decrease in the concentration of CSF–1 in women of subgroup A. Conclusions. CSF–1 is 1.4 times higher in the menstrual blood of women with ED. The use of complex treatment of ED should include not only surgical, but also supportive conservative therapy. Hormone therapy does not cure ED, but it stabilizes it. Priority in the choice of hormone therapy drugs should be given to drugs containing dienogest. Determination of CSF–1 in menstrual blood can be used as a non–invasive method for monitoring the course of ED.

endometrioid disease, menstrual blood, hormone therapy.

1. Zaporozhan VM, Tatarchuk TF, Kaminskyi VV, Boichuk AV, Bulavenko OV, Vdovychenko YuP, et al. Natsionalnyi konsensus shchodo vedennia patsiientok iz endometriozom. Reproduktyvna endokrynolohiia. 2015 Ver;4(24):7-12. DOI: 10.18370/2309–4117.2015.24.7–12. [in Ukrainian].
2. Kononov AV, Mozgovoy SI, Mozgovaya EI, Novikov DG. Endometrioz: teorii proiskhozhdeniya. Omsk nauch vestnik. 2008;1(65):32-36. Dostupno: https://cyberleninka.ru/article/n/endometrioz-teorii-proishozhdeniya. [in Russian].
3. Wang Y, Nicholes K, Shih IM. The Origin and Pathogenesis of Endometriosis. Annu Rev Pathol. 2020;15:71-95. DOI: 10.1146/annurev– pathmechdis–012419–032654.
4. Hwang H, Chung YJ, Lee SR, Park HT, Song JY, Kim H, et al. Clinical evaluation and management of endometriosis: guideline for Korean patients from Korean Society of Endometriosis. Obstet Gynecol Sci. 2018 Sep;61(5):553-564. DOI: 10.5468/ogs.2018.61.5.553.
5. Novikova EI, Barinov SV, Mozgovoy SI, Vasilenko LN. Novye podkhody k diagnostike genital’nogo endometrioza. Omskiy nauchnyy vestnik. 2012;1(108):46-48. Dostupno: https://cyberleninka.ru/article/n/novye-podhody-k-diagnostike-genitalnogo-endometrioza. [in Russian].
6. Ulrich U, Buchweitz O, Greb R, Keckstein J, Ivon L, Oppelt P, at al. National German Guideline (S2K). Guideline for Diagnosis and Treatment of Endometriosis, AWMF Registry No 015–045. Geburtsh Frauenheilk. 2014;74:1104-1118. DOI: 10.1055/s–0034–1383187.
7. Wee-Stekly WW, Kew CCY, Chern BSM. Endometriosis:Areview of the diagnosis and pain management. Gynecology and Minimally Invasive Therapy. 2015;5(4):106-109 DOI: 10.1016/j.gmit.2015.06.005.
8. Burns KA, Thomas SY, Hamilton KJ, Young SL, Cook DN, Korach KS. Early Endometriosis in Females Is Directed by Immune –Mediated Estrogen Receptor α and IL-6 Cross-Talk. Endocrinology. 2018;159(1):103-118. DOI: 10.1210/en.2017–00562.
9. Orlova YA, Hromova AM, Kaidashev IP, Shlykova OA, Izmailova OV, Martynenko VB. Pathogenetic role of macrophage colony–stimulating factor (csf–1) in predicting endometrioid disease. Wiad Lek. 2021;74(8):1939-1944. DOI: 10.36740/WLek202108128.
10. Nakaz MOZ Ukrainy № 319 vid 06.04.2016 roky. Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy: «Taktyka vedennia patsiientok z henitalnym endometriozom». Dostupno: https://www. dec.gov. ua/mtd/genitalnyj-endometrioz/. [in Ukrainian]
11. Orlova YuA. Porivnialna kharakterystyka (vypadok–kontrol) zhinok z ta bez endometrioidnoi khvoroby. Aktualni problemy suchasnoi medytsyny: Visnyk Ukrainskoi medychnoi stomatolohichnoi akademii. 2021;21(3):93-99. DOI: 10.31718/2077–1096.21.3.93. [in Ukrainian]
12. Barinov SV, Novikova EI, Vasilenko LN. Znachenie klinicheskikh faktorov riska retsidiva naruzhnogo genital’nogo endometrioza. Mat’ i ditya v Kuzbasse. 2013;4(55):45-48. Dostupno: https://cyberleninka.ru/article/n/ znachenie-klinicheskih-faktorov-riska-retsidiva-naruzhnogogenitalnogo-endometrioza. [in Russian]

«Bulletin of problems biology and medicine» Issue 4 (162), 2021 year, 155-158 pages, index UDK 618.14-002-089.8-085

10.29254/2077-4214-2021-4-162-155-158