Immunohistochemical features of uterine myoma and endometrial tumors in patients during the menopausal transition

The immunohistochemical profile of uterine myoma and endometrium in women during the menopausal transition (perimenopause) has been poorly studied, although hormonal changes during this period may influence the pathogenesis of the disease and the condition of the endometrium. Objective. To compare the expression of the proliferation marker Ki-67, estrogen receptors (ER), progesterone receptors (PR), and apoptosis marker Bcl-2 in myomatous nodes and the endometrium of perimenopausal women with and without uterine myoma. Materials and methods. A retrospective study was conducted, including 37 patients: 16 in the study group with uterine myoma and 21 in the comparison group without myoma, who had undergone hysterectomy. Marker expression in tissues was assessed using the indirect immunoperoxidase reaction on paraffin sections. Results were assessed using the H-score and proliferation index. Statistical analysis was performed using the Mann—Whitney test, Spearman correlation, Fisher’s exact test, and the Bonferroni correction. Results. In the endometrial glands of the study group, increased expression of the apoptosis marker Bcl-2 was detected, which remained statistically significant after Bonferroni correction for multiple comparisons. No statistically significant differences in the expression of ER, PR, and Ki-67 were found between the groups. Correlation analysis between marker expression in the myomatous node and the endometrium revealed no statistically significant relationships. Conclusion. The presence of uterine myoma in perimenopause is associated with increased Bcl-2 expression in the endometrial glands, indicating suppression of apoptosis. The absence of statistically significant correlations between the immunohistochemical profiles of the endometrium and myomatous node indicates their relative independence and the limited prognostic value of endometrial biopsy for characterizing myoma tissue.