Orazov MR, Mikhaleva LM, Poymanova OF, Mullina IA. Pathogenesis mechanisms of endometrial polyps in women of reproductive age: a literature review. Gynecology. 2022;24(4):246–250. DOI: 10.26442/20795696.2022.4.201807
Механизмы патогенеза эндометриальных полипов у женщин репродуктивного возраста. Обзор литературы
Orazov MR, Mikhaleva LM, Poymanova OF, Mullina IA. Pathogenesis mechanisms of endometrial polyps in women of reproductive age: a literature review. Gynecology. 2022;24(4):246–250. DOI: 10.26442/20795696.2022.4.201807
Эндометриальный полип (ЭП) – частая случайная находка при гистероскопии у бессимптомных пациенток. К настоящему времени патогенез ЭП до конца не раскрыт, что затрудняет первичную и вторичную профилактику ЭП, их таргетную терапию. Это обстоятельство определило направленность нашей работы. Нами выполнен поиск научных публикаций в базах данных Cochrane Library, ScienceDirect, PubMed (MEDLINE), eLIBRARY по ключевым словам «polyps»/«полипы», «endometrial polyps»/«полипы эндометрия», «pathogenesis»/«патогенез», «reproductive age»/«репродуктивный возраст», «recidive»/«рецидив» за 2012–2022 гг. Анализ данных литературы позволил сделать вывод, что в патогенезе ЭП, вероятнее всего, задействован не один, а несколько механизмов, как эстроген-опосредованных (гиперэстрогения, в том числе на фоне нарушенной рецепции и дефицита прогестерона), так и негормональных (воспалительных, иммунных, генетических факторов, неоангиогенеза). По-видимому, гормональные и негормональные факторы приводят к нарушению нормальных циклических изменений эндометрия в течение менструального цикла, нарушают баланс и динамику процессов пролиферации и апоптоза, инициируют неоангиогенез, что служит разрешающим механизмом полипообразования, персистенции ЭП и их рецидивирования после оперативного удаления. Целью нашей работы было проанализировать и обобщить накопленные к настоящему времени научные данные о механизмах патогенеза ЭП у женщин репродуктивного возраста.
Endometrial polyp (EP) is a frequent incidental finding during hysteroscopy in asymptomatic patients. To date, the pathogenesis of EPs has not been fully disclosed, which challenges the primary and secondary prevention of EPs and their targeted therapy. It determined the focus of our work. We searched for scientific publications in Cochrane Library, ScienceDirect, PubMed (MEDLINE), eLIBRARY using the keywords "polyps", "endometrial polyps", "pathogenesis", "reproductive age", "recidive" for 2012–2022. Analysis of the literature data allowed us to conclude that ES pathogenesis most likely involves several mechanisms, both estrogen-mediated (hyperestrogenism, including related to impaired progesterone reception and deficiency) and non-hormonal (inflammatory, immune, genetic factors, neoangiogenesis). Hormonal and non-hormonal factors disturb normal cyclic changes of the endometrium during the menstrual cycle, alter the balance and dynamics of proliferation and apoptosis, and initiate neoangiogenesis that serves as a resolving mechanism of polyposis formation, persistence of ES, and their recurrence after surgical removal. The objective of our study was to analyze and summarize the scientific data available on the mechanisms of ES pathogenesis in women of reproductive age.
1. Tanos V, Berry KE, Seikkula J, et al. The management of polyps in female reproductive organs. Int J Surg. 2017;43:7-16. DOI:10.1016/j.ijsu.2017.05.012
2. de Azevedo JM, de Azevedo LM, Freitas F, Wender MC. Endometrial polyps: when to resect? Arch Gynecol Obstet. 2016;293(3):639-43. DOI:10.1007/s00404-015-3854-3
3. Yuksel S, Tuna G, Celik HG, Salman S. Endometrial polyps: Is the prediction of spontaneous regression possible? Obstet Gynecol Sci. 2021;64(1):114-21. DOI:10.5468/ogs.20242
4. Sheng KK, Lyons SD. To treat or not to treat? An evidence-based practice guide for the management of endometrial polyps. Climacteric. 2020;23(4):336-42. DOI:10.1080/13697137.2020.1742107
5. American Association of Gynecologic Laparoscopists. AAGL practice report: practice guidelines for the diagnosis and management of endometrial polyps. J Minim Invasive Gynecol. 2012;19(1):3-10. DOI:10.1016/j.jmig.2011.09.003
6. Unal B, Doğan S, Karaveli FŞ, et al. Giant Endometrial Polyp in a Postmenopausal Woman without Hormone/Drug Use and Vaginal Bleeding. Case Rep Obstet Gynecol. 2014;2014:518398. DOI:10.1155/2014/518398
7. Zhang H, He X, Tian W, et al. Hysteroscopic Resection of Endometrial Polyps and Assisted Reproductive Technology Pregnancy Outcomes Compared with No Treatment: A Systematic Review. J Minim Invasive Gynecol. 2019;26(4):618-27. DOI:10.1016/j.jmig.2018.10.024
8. Haque M, Mneimneh W. Endometrial polyp. PathologyOutlines.com, 2018. Available at: http://www.pathologyoutlines.com/topic/uterusendopolyp.html. Accessed: 12.08.2022.
9. Szeszko Ł, Oszukowski P, Kisiel A, et al. Histopathological results analysis in women undergoing hysteroscopic procedures due to endometrial polyps. Health Problems of Civilization. 2019;13(2):99-103. DOI:10.5114/hpc.2019.81340
10. Uglietti A, Buggio L, Farella M, et al. The risk of malignancy in uterine polyps: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2019;237:48-56. DOI:10.1016/j.ejogrb.2019.04.009
11. Vitale SG, Haimovich S, Laganà AS, et al. Endometrial polyps. An evidence-based diagnosis and management guide. Eur J Obstet Gynecol Reprod Biol. 2021;260:70-7. DOI:10.1016/j.ejogrb.2021.03.017
12. Багдасарян Л.Ю., Пономарев В.В., Карахалис Л.Ю., и др. Факторы, влияющие на развитие полипов эндометрия. Кубанский научный медицинский вестник. 2018;25(2):25-8 [Bagdasaryan LYu, Ponomarev VV, Karakhalis LYu, et al. Factors influencing the development of endometrial polyps. Kuban Scientific Medical Bulletin. 2018;25(2):25-8 (in Russian)]. DOI:10.25207/1608-6228-2018-25-2-25-28
13. Lieng M, Istre O, Sandvik L, Qvigstad E. Prevalence, 1-year regression rate, and clinical significance of asymptomatic endometrial polyps: cross-sectional study. J Minim Invasive Gynecol. 2009;16(4):465-71. DOI:10.1016/j.jmig.2009.04.005
14. Wong M, Crnobrnja B, Liberale V, et al. The natural history of endometrial polyps. Hum Reprod. 2017;32(2):340-5. DOI:10.1093/humrep/dew307
15. Кулигин А.В., Астафьева Е.В., Самсонова А.И., Кочедаева Т.Д. Патофизиологические основы аномальных маточных кровотечений. Клиническая патофизиология. 2021;27(4):27-34 [Kuligin AV, Astafieva EV, Samsonova AI, Kochedaeva TD. Pathophysiologycal basics of abnormal uterine bleeding. Clinical Pathophysiology. 2021;27(4):27-34 (in Russian)].
16. Indraccolo U, Di Iorio R, Matteo M, et al. The pathogenesis of endometrial polyps: a systematic semi-quantitative review. Eur J Gynaecol Oncol. 2013;34(1):5-22.
17. Иванов А.С., Гребнева В.В. Эндометриальный полип. Вопросы этиологии и патогенеза. Известия Российской военно-медицинской академии. 2020;2(S1):75-7 [Ivanov AS, Grebneva VV. Endometrial polyps. Questions of etiology and pathogenesis. Russian Military Medical Academy Reports. 2020;2(S1):75-7 (in Russian)].
DOI:10.17816/rmmar43357
18. Lopes RG, Baracat EC, de Albuquerque Neto LC, et al. Analysis of estrogen- and progesterone-receptor expression in endometrial polyps. J Minim Invasive Gynecol. 2007;14(3):300-3. DOI:10.1016/j.jmig.2006.10.022
19. Mittal K, Schwartz L, Goswami S, Demopoulos R. Estrogen and progesterone receptor expression in endometrial polyps. Int J Gynecol Pathol. 1996;15(4):345-8. DOI:10.1097/00004347-199610000-00007
20. Taylor LJ, Jackson TL, Reid JG, Duffy SR. The differential expression of oestrogen receptors, progesterone receptors, Bcl-2 and Ki67 in endometrial polyps. BJOG. 2003;110(9):794-8.
21. Mourits MJE, Hollema H, De Vries EG, et al. Apoptosis and apoptosis-associated parameters in relation to tamoxifen exposure in postmenopausal endometrium. Hum Pathol. 2002;33(3):341-6. DOI:10.1053/hupa.2002.32226
22. Altaner S, Gucer F, Tokatli F, et al. Expression of Bcl-2 and Ki-67 in tamoxifen-associated endometrial polyps: comparison with postmenopausal polyps. Onkologie. 2006;29(8-9):376-80. DOI:10.1159/000094443
23. Antunes A Jr, Andrade LA, Pinto GA, et al. Is the immunohistochemical expression of proliferation (Ki-67) and apoptosis (Bcl-2) markers and cyclooxigenase-2 (COX-2) related to carcinogenesis in postmenopausal endometrial polyps? Anal Quant Cytopathol Histpathol. 2012;34(5):264-72.
24. Atak Z, Turhan EI, Rahimli Ocakoglu S, Uyaniklar OO. Symptom-related Ki-67 expression in endometrial polyps. Eur J Obstet Gynecol Reprod Biol. 2022;272:139-43. DOI:10.1016/j.ejogrb.2022.03.022
25. Moskalewicz A, Di Tomaso A, Kachura JJ, et al. Gynecologic Symptoms among Hormone Receptor-Positive Breast Cancer Patients on Oral Endocrine Therapy: A Cross-Sectional Study. Curr Oncol. 2022;29(3):1813-27. DOI:10.3390/curroncol29030149
26. Drizi A, Djokovic D, Laganà AS, van Herendael B. Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions. Prz Menopauzalny. 2020;19(2):90-100. DOI:10.5114/pm.2020.97863
27. Иванов И.А., Асатурова А.В., Чернуха Г.Е., и др. Роль патологического неоангиогенеза в формировании полипов эндометрия и механизмы возникновения аномальных маточных кровотечений. Клиническая и экспериментальная морфология. 2019;8(2):28-34 [Ivanov IA, Asaturova AV, Chernukha GE, et al. The role of pathological angiogenesis in endometrial polyp pathogenesis and abnormal uterine bleeding. Clin exp morphology. 2019;8(2):28-34 (in Russian)]. DOI:10.31088/2226-5988-2019-30-2-28-34
28. Li L, Zhong L, Tang C, et al. CD105: tumor diagnosis, prognostic marker and future tumor therapeutic target. Clin Transl Oncol. 2022;24(8):1447-58. DOI:10.1007/s12094-022-02792-0
29. Yao T, Chen H, Wang R, et al. Thiol-ene conjugation of VEGF peptide to electrospun scaffolds as potential application for angiogenesis. Bioact Mater. 2022;20:306-17. DOI:10.1016/j.bioactmat.2022.05.029
30. Son JA, Lee SK, Park J, et al. Platycodin D Inhibits Vascular Endothelial Growth Factor-Induced Angiogenesis by Blocking the Activation of Mitogen-Activated Protein Kinases and the Production of Interleukin-8. Am J Chin Med. 2022:1-17. DOI:10.1142/S0192415X22500690
31. Chen L, Deng H, Cui H, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2017;9(6):7204-18. DOI:10.18632/oncotarget.23208
32. Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019;7:2050312119848247. DOI:10.1177/2050312119848247
33. Zakrzewski PK. Canonical TGFβ Signaling and Its Contribution to Endometrial Cancer Development and Progression-Underestimated Target of Anticancer Strategies. J Clin Med. 2021;10(17):3900. DOI:10.3390/jcm10173900
34. Vitagliano A, Cialdella M, Cicinelli R, et al. Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis. Diagnostics (Basel). 2021;11(12):2182. DOI:10.3390/diagnostics11122182
35. Carvalho FM, Aguiar FN, Tomioka R, et al. Functional endometrial polyps in infertile asymptomatic patients: a possible evolution of vascular changes secondary to endometritis. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):152-6. DOI:10.1016/j.ejogrb.2013.05.012
36. Schatz F, Guzeloglu-Kayisli O, Arlier S, et al. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding. Hum Reprod Update. 2016;22(4):497-515. DOI:10.1093/humupd/dmw004
37. Vallvé-Juanico J, Houshdaran S, Giudice LC. The endometrial immune environment of women with endometriosis. Hum Reprod Update. 2019;25(5):564-91. DOI:10.1093/humupd/dmz018
38. Wu J, Feng X, Du Y, et al. β-catenin/LIN28B promotes the proliferation of human choriocarcinoma cells via Let-7a repression. Acta Biochim Biophys Sin (Shanghai). 2019;51(5):455-62. DOI:10.1093/abbs/gmz027
39. Li XH, Lu MY, Li YJ, et al. Circulating PD1+Vδ1+γδ T Cell Predicts Fertility in Endometrial Polyp Patients of Reproductive-Age. Front Immunol. 2021;12:639221. DOI:10.3389/fimmu.2021.639221
40. Zhu Y, Liu Z, Du M, et al. Macrophages in patients with recurrent endometrial polyps could exacerbate Th17 responses. Clin Exp Pharmacol Physiol. 2018;45(11):1128-34. DOI:10.1111/1440-1681.12994
41. Cicinelli E, Bettocchi S, de Ziegler D, et al. Chronic Endometritis, a Common Disease Hidden Behind Endometrial Polyps in Premenopausal Women: First Evidence From a Case-Control Study. J Minim Invasive Gynecol. 2019;26(7):1346-50. DOI:10.1016/j.jmig.2019.01.012
42. Lu MY, Li XH, Niu JL, Liu B. LIN28B Polymorphisms Confer a Higher Postoperative Recurrence Risk in Reproductive-Age Women with Endometrial Polyps. Dis Markers. 2022;2022:4824357. DOI:10.1155/2022/4824357
43. Nomiyama M, Yamasaki F, Tokunaga M, et al. Endometrial polyps with increased plasma cells are associated with chronic endometritis in infertility patients: Hysteroscopic findings and post-polypectomy pregnancy rates. Reprod Med Biol. 2021;20(4):494-504. DOI:10.1002/rmb2.12394
________________________________________________
1. Tanos V, Berry KE, Seikkula J, et al. The management of polyps in female reproductive organs. Int J Surg. 2017;43:7-16. DOI:10.1016/j.ijsu.2017.05.012
2. de Azevedo JM, de Azevedo LM, Freitas F, Wender MC. Endometrial polyps: when to resect? Arch Gynecol Obstet. 2016;293(3):639-43. DOI:10.1007/s00404-015-3854-3
3. Yuksel S, Tuna G, Celik HG, Salman S. Endometrial polyps: Is the prediction of spontaneous regression possible? Obstet Gynecol Sci. 2021;64(1):114-21. DOI:10.5468/ogs.20242
4. Sheng KK, Lyons SD. To treat or not to treat? An evidence-based practice guide for the management of endometrial polyps. Climacteric. 2020;23(4):336-42. DOI:10.1080/13697137.2020.1742107
5. American Association of Gynecologic Laparoscopists. AAGL practice report: practice guidelines for the diagnosis and management of endometrial polyps. J Minim Invasive Gynecol. 2012;19(1):3-10. DOI:10.1016/j.jmig.2011.09.003
6. Unal B, Doğan S, Karaveli FŞ, et al. Giant Endometrial Polyp in a Postmenopausal Woman without Hormone/Drug Use and Vaginal Bleeding. Case Rep Obstet Gynecol. 2014;2014:518398. DOI:10.1155/2014/518398
7. Zhang H, He X, Tian W, et al. Hysteroscopic Resection of Endometrial Polyps and Assisted Reproductive Technology Pregnancy Outcomes Compared with No Treatment: A Systematic Review. J Minim Invasive Gynecol. 2019;26(4):618-27. DOI:10.1016/j.jmig.2018.10.024
8. Haque M, Mneimneh W. Endometrial polyp. PathologyOutlines.com, 2018. Available at: http://www.pathologyoutlines.com/topic/uterusendopolyp.html. Accessed: 12.08.2022.
9. Szeszko Ł, Oszukowski P, Kisiel A, et al. Histopathological results analysis in women undergoing hysteroscopic procedures due to endometrial polyps. Health Problems of Civilization. 2019;13(2):99-103. DOI:10.5114/hpc.2019.81340
10. Uglietti A, Buggio L, Farella M, et al. The risk of malignancy in uterine polyps: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2019;237:48-56. DOI:10.1016/j.ejogrb.2019.04.009
11. Vitale SG, Haimovich S, Laganà AS, et al. Endometrial polyps. An evidence-based diagnosis and management guide. Eur J Obstet Gynecol Reprod Biol. 2021;260:70-7. DOI:10.1016/j.ejogrb.2021.03.017
12. Bagdasaryan LYu, Ponomarev VV, Karakhalis LYu, et al. Factors influencing the development of endometrial polyps. Kuban Scientific Medical Bulletin. 2018;25(2):25-8 (in Russian). DOI:10.25207/1608-6228-2018-25-2-25-28
13. Lieng M, Istre O, Sandvik L, Qvigstad E. Prevalence, 1-year regression rate, and clinical significance of asymptomatic endometrial polyps: cross-sectional study. J Minim Invasive Gynecol. 2009;16(4):465-71. DOI:10.1016/j.jmig.2009.04.005
14. Wong M, Crnobrnja B, Liberale V, et al. The natural history of endometrial polyps. Hum Reprod. 2017;32(2):340-5. DOI:10.1093/humrep/dew307
15. Kuligin AV, Astafieva EV, Samsonova AI, Kochedaeva TD. Pathophysiologycal basics of abnormal uterine bleeding. Clinical Pathophysiology. 2021;27(4):27-34 (in Russian).
16. Indraccolo U, Di Iorio R, Matteo M, et al. The pathogenesis of endometrial polyps: a systematic semi-quantitative review. Eur J Gynaecol Oncol. 2013;34(1):5-22.
17. Ivanov AS, Grebneva VV. Endometrial polyps. Questions of etiology and pathogenesis. Russian Military Medical Academy Reports. 2020;2(S1):75-7 (in Russian).
DOI:10.17816/rmmar43357
18. Lopes RG, Baracat EC, de Albuquerque Neto LC, et al. Analysis of estrogen- and progesterone-receptor expression in endometrial polyps. J Minim Invasive Gynecol. 2007;14(3):300-3. DOI:10.1016/j.jmig.2006.10.022
19. Mittal K, Schwartz L, Goswami S, Demopoulos R. Estrogen and progesterone receptor expression in endometrial polyps. Int J Gynecol Pathol. 1996;15(4):345-8. DOI:10.1097/00004347-199610000-00007
20. Taylor LJ, Jackson TL, Reid JG, Duffy SR. The differential expression of oestrogen receptors, progesterone receptors, Bcl-2 and Ki67 in endometrial polyps. BJOG. 2003;110(9):794-8.
21. Mourits MJE, Hollema H, De Vries EG, et al. Apoptosis and apoptosis-associated parameters in relation to tamoxifen exposure in postmenopausal endometrium. Hum Pathol. 2002;33(3):341-6. DOI:10.1053/hupa.2002.32226
22. Altaner S, Gucer F, Tokatli F, et al. Expression of Bcl-2 and Ki-67 in tamoxifen-associated endometrial polyps: comparison with postmenopausal polyps. Onkologie. 2006;29(8-9):376-80. DOI:10.1159/000094443
23. Antunes A Jr, Andrade LA, Pinto GA, et al. Is the immunohistochemical expression of proliferation (Ki-67) and apoptosis (Bcl-2) markers and cyclooxigenase-2 (COX-2) related to carcinogenesis in postmenopausal endometrial polyps? Anal Quant Cytopathol Histpathol. 2012;34(5):264-72.
24. Atak Z, Turhan EI, Rahimli Ocakoglu S, Uyaniklar OO. Symptom-related Ki-67 expression in endometrial polyps. Eur J Obstet Gynecol Reprod Biol. 2022;272:139-43. DOI:10.1016/j.ejogrb.2022.03.022
25. Moskalewicz A, Di Tomaso A, Kachura JJ, et al. Gynecologic Symptoms among Hormone Receptor-Positive Breast Cancer Patients on Oral Endocrine Therapy: A Cross-Sectional Study. Curr Oncol. 2022;29(3):1813-27. DOI:10.3390/curroncol29030149
26. Drizi A, Djokovic D, Laganà AS, van Herendael B. Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions. Prz Menopauzalny. 2020;19(2):90-100. DOI:10.5114/pm.2020.97863
27. Ivanov IA, Asaturova AV, Chernukha GE, et al. The role of pathological angiogenesis in endometrial polyp pathogenesis and abnormal uterine bleeding. Clin exp morphology. 2019;8(2):28-34 (in Russian). DOI:10.31088/2226-5988-2019-30-2-28-34
28. Li L, Zhong L, Tang C, et al. CD105: tumor diagnosis, prognostic marker and future tumor therapeutic target. Clin Transl Oncol. 2022;24(8):1447-58. DOI:10.1007/s12094-022-02792-0
29. Yao T, Chen H, Wang R, et al. Thiol-ene conjugation of VEGF peptide to electrospun scaffolds as potential application for angiogenesis. Bioact Mater. 2022;20:306-17. DOI:10.1016/j.bioactmat.2022.05.029
30. Son JA, Lee SK, Park J, et al. Platycodin D Inhibits Vascular Endothelial Growth Factor-Induced Angiogenesis by Blocking the Activation of Mitogen-Activated Protein Kinases and the Production of Interleukin-8. Am J Chin Med. 2022:1-17. DOI:10.1142/S0192415X22500690
31. Chen L, Deng H, Cui H, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2017;9(6):7204-18. DOI:10.18632/oncotarget.23208
32. Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019;7:2050312119848247. DOI:10.1177/2050312119848247
33. Zakrzewski PK. Canonical TGFβ Signaling and Its Contribution to Endometrial Cancer Development and Progression-Underestimated Target of Anticancer Strategies. J Clin Med. 2021;10(17):3900. DOI:10.3390/jcm10173900
34. Vitagliano A, Cialdella M, Cicinelli R, et al. Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis. Diagnostics (Basel). 2021;11(12):2182. DOI:10.3390/diagnostics11122182
35. Carvalho FM, Aguiar FN, Tomioka R, et al. Functional endometrial polyps in infertile asymptomatic patients: a possible evolution of vascular changes secondary to endometritis. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):152-6. DOI:10.1016/j.ejogrb.2013.05.012
36. Schatz F, Guzeloglu-Kayisli O, Arlier S, et al. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding. Hum Reprod Update. 2016;22(4):497-515. DOI:10.1093/humupd/dmw004
37. Vallvé-Juanico J, Houshdaran S, Giudice LC. The endometrial immune environment of women with endometriosis. Hum Reprod Update. 2019;25(5):564-91. DOI:10.1093/humupd/dmz018
38. Wu J, Feng X, Du Y, et al. β-catenin/LIN28B promotes the proliferation of human choriocarcinoma cells via Let-7a repression. Acta Biochim Biophys Sin (Shanghai). 2019;51(5):455-62. DOI:10.1093/abbs/gmz027
39. Li XH, Lu MY, Li YJ, et al. Circulating PD1+Vδ1+γδ T Cell Predicts Fertility in Endometrial Polyp Patients of Reproductive-Age. Front Immunol. 2021;12:639221. DOI:10.3389/fimmu.2021.639221
40. Zhu Y, Liu Z, Du M, et al. Macrophages in patients with recurrent endometrial polyps could exacerbate Th17 responses. Clin Exp Pharmacol Physiol. 2018;45(11):1128-34. DOI:10.1111/1440-1681.12994
41. Cicinelli E, Bettocchi S, de Ziegler D, et al. Chronic Endometritis, a Common Disease Hidden Behind Endometrial Polyps in Premenopausal Women: First Evidence From a Case-Control Study. J Minim Invasive Gynecol. 2019;26(7):1346-50. DOI:10.1016/j.jmig.2019.01.012
42. Lu MY, Li XH, Niu JL, Liu B. LIN28B Polymorphisms Confer a Higher Postoperative Recurrence Risk in Reproductive-Age Women with Endometrial Polyps. Dis Markers. 2022;2022:4824357. DOI:10.1155/2022/4824357
43. Nomiyama M, Yamasaki F, Tokunaga M, et al. Endometrial polyps with increased plasma cells are associated with chronic endometritis in infertility patients: Hysteroscopic findings and post-polypectomy pregnancy rates. Reprod Med Biol. 2021;20(4):494-504. DOI:10.1002/rmb2.12394
1 ФГАОУ ВО «Российский университет дружбы народов», Москва, Россия;
2 ФГБНУ «Российский научный центр хирургии им. акад. Б.В. Петровского», Москва, Россия
*omekan@mail.ru
________________________________________________
Mekan R. Orazov*1, Liudmila M. Mikhaleva2, Olga F. Poymanova1, Irina A. Mullina1
1 People’s Friendship University of Russia (RUDN University), Moscow, Russia;
2 Petrovsky National Research Centre of Surgery, Moscow, Russia
*omekan@mail.ru