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HYPERPLASTIC, DYSTROPHIC AND TUMOR DISEASES OF THE FEMALE GENITAL ORGANS AND MAMMARY GLANDS

Hyperplastic and dystrophic processes of the female genital organs, as a rule, serve as one of the manifestations of the pathology of the endocrine and immune systems, as well as inflammatory processes of the genitals. They can also be induced by various environmental and hereditary factors. At the same time, hyperplastic and dystrophic changes often precede the development of malignant neoplasms in the body.

Hyperplasia and dystrophy of tissues is their excessive and often abnormal development due to accelerated or often atypical cell proliferation. Therefore, in the treatment of hyperplastic and dystrophic changes (processes) of tissues and organs, two points should be taken into account: how to eliminate the factors that caused them, and how to prevent their transformation into malignant neoplasms.

To date, there are no pathognomonic only histological signs of hyperplastic processes that would certainly clearly indicate an increased risk of cancer. Even processes such as metaplasia, hyperplasia and atrophy, only taking into account the clinical symptoms, can be evaluated at the risk of developing malignant neoplasms. However, these combinations are difficult to describe clearly. Even with appropriate morphological changes and a specific clinical picture, the risk of developing cancer can be expressed only in general terms, and an accurate prognosis for the patient is almost impossible. The fact is that some morphological changes, even at the atypia level, can persist for many years, can regress, and finally, can progress to a malignant neoplasm.

The etiology and pathogenesis of hyperplastic processes is considered as the cause of malignant growth. Success in its study is associated with the achievements of molecular biology, biochemistry, genetics, endocrinology, immunology and microbiology. The important role of genetic, hormonal and immunological mechanisms is shown. Particular importance is attached to chronic inflammatory processes of bacterial and viral origin. However, as for malignant growth, the causes of hyperplastic and dystrophic changes have not been conclusively established. Therefore, in clinical studies, the emphasis is more on the pathogenesis of these diseases.

In terms of age, it can be noted that hyperplastic processes of the cervix are observed during all periods of a woman’s life, and the endometrium, to a greater extent, after 40–45 years, due to various conditions of the reproductive organs. In particular, this is due to the progression in women of metabolic disorders and immunosuppressive conditions at an older age. In addition, in the development of pathological processes of the mucous genital organs, their involutive changes can play an important role.

Assessing the role of immune mechanisms in the development of hyperplastic and tumor processes of the female genital organs, one should keep in mind those multilateral mechanisms that are involved in the regulation of immune homeostasis. This is especially evident in hyperplastic processes and endometrial cancer in women of the perimenopausal period. Along with the involuntary processes of the reproductive system, they also develop a lack of immunological control of transformed tumor cells. Well-known hormonal disorders of this period affect both the transformation of endometrial cells and the state of immunity.

Therefore, characterizing the causative factors of hyperplastic processes and endometrial cancer, one should dwell on the use of estrogen in the postmenopausal period for the treatment and prevention of cardiovascular pathology, osteoporosis and atrophic changes in the genital organs. There is evidence that the increase in the tumor processes of the endometrium, ovaries and mammary gland proceeds in parallel with the increased use of estrogen in the postmenopausal period as replacement therapy in economically developed countries and especially the USA (Y.V. Bohman, 1989). The risk of endometrial cancer in women taking estrogen in postmenopausal women is many times (5-7 times) higher than in women who do not use them. Moreover, the degree of this risk depends on the dose and duration of estrogen therapy. Long is considered the period of use of estrogen for more than a year. We can say that the main factor in the proliferation of the endometrium and the sequential development of glandular hyperplasia, atypical hyperplasia and endometrial cancer is absolute or relative hyperestrogenia. It can be the background for these processes, especially in the absence of antiestrogenic effects of gestagens.
Hyperplastic changes in the endometrium develop with hyperestrogenism due to anovulation in the reproductive and premenopausal periods, hyperplasia of the ovarian techa tissue in pre- and postmenopausal women, and also due to the increased conversion of androstenedione to estrone in adipose tissue with obesity neuroendocrine syndromes. Endocrine disorders contribute to the development of hyperplastic processes not only in the endometrium, but also in the ovaries, and the pathology of the ovaries develops to a greater extent with violations of the pituitary gonadotropic function.

Outlining data on the role of endocrine disorders in the development of hyperplastic processes of the female genital organs, it is necessary to note the appearance of anovulatory cycles in women simultaneously with the use of steroidal contraceptives. An increase in the frequency of dysplasia and pre-invasive cancer of uterine cells in women using steroid contraceptives compared with the general population has been shown (WHO Bulletin, 1986, No. 4). In general, there are many different opinions on this issue, as well as on the protective role of steroid contraceptives for endometrial and breast hyperplastic processes.

Of great importance in the induction of hyperplastic processes of the genital organs in women is radiation, especially in the environmental conditions of Belarus. This question remains under study. More investigated are induced tumors in women during the course of radiation therapy, as well as those arising under the influence of radiation in experimental conditions. However, taking into account these data and a significant increase in tumor processes in Belarus after the accident at the Chernobyl nuclear power plant, ionizing radiation can be completely characterized as a factor in the induction of hyperplastic tumor changes in the genitals in women.

Thus, the hyperplastic and dystrophic processes of the female genital organs are diseases of multifactorial origin with the same development mechanism.

The most common causes of induction of hyperplastic processes are: for the vulva of the vagina - involutive changes, viruses, inflammatory processes, hygiene disorders; for the cervix - the early onset of sexual activity and the frequent change of sexual partners, trauma, inflammatory processes of bacterial and viral origin, hormonal disorders, steroid contraception; for the endometrium - absolute and relative hyperestrogenism, other hormonal disorders, lack of sex life, infertility, a protracted premenopausal period, the use of estrogen in postmenopausal women, metabolic disorders (obesity, diabetes mellitus, etc.), all diseases and conditions with anovulation; for ovaries - hormonal disorders with hyperestrogenia, lack of sex life and infertility, late menopause, genital tumors and endometriosis of other localizations, metabolic disorders; for the mammary gland - hormonal disorders, mainly with hyperestrogenia, infertility and lack of sex life, metabolic disorders, estrogen administration in postmenopausal women, uterine fibroids and tumors of other locations. In all cases, great importance is attached to genetic factors - burdened by heredity in oncology.

Clinically, hyperplastic and dystrophic processes of the female genital organs are considered according to organ localization, since the staged development of background diseases - precancer - tumor growth for each organ, along with general patterns, have their own specific features.

The doctrine of pre-tumor processes received particular development after the International Congress on Oncology, held in 1961, which was devoted to this problem.

It was then that the terms “background diseases” and “precancer” (“precancerous conditions”) with their morphological and clinical characteristics were defined. The special significance of highlighting such terms and concepts is that the real ways of preventing malignant neoplasms have been shown. There was a classification for their separation into pre-invasive (carcinoma in situ, stage 0, intraepithelial carcinoma) and invasive forms (stages I-IV). The opinion began to be affirmed that cancer does not develop on healthy tissue, it is always preceded by some pathological changes. Focused on the study of recent conditions. Their diagnosis and timely treatment are still the basis for cancer prevention.
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HYPERPLASTIC, DYSTROPHIC AND TUMOR DISEASES OF THE FEMALE GENITAL ORGANS AND MAMMARY GLANDS

  1. Hyperplastic, dysplastic and tumor processes of the mammary gland
    The reproductive system of a woman along with the genitals includes the mammary glands. The tissues of the latter are targets not only for prolactin, but also for sex steroid hormones, gonadotropic hormones, and hormones of other endocrine glands. A special science is identified - mammology, which deals with the physiology and pathology of the mammary gland. Developing and functioning as much as possible in the postpartum period
  2. Diseases of the female genital organs and mammary glands. Pathology of pregnancy.
    Diseases of the female genital organs are divided into: 1) dishormonal; 2) inflammatory: 3) tumor. Among dishormonal diseases, glandular hyperplasia of the uterine mucosa and uterine pseudo-erosion are frequent. With glandular endometrial hyperplasia, its sharp thickening occurs due to polypous outgrowths. Histologically distinguish glandular-cystic and atypical hyperplasia, or diffuse
  3. Diseases of the female genital organs and mammary glands.
    1. The term "transformation zone" is understood to mean 1. healing endocervicosis 2. line of connection between ecto- and endocervix 3. anatomical border between the cervix and uterine body 2. Cervical intraepithelial neoplasia is a stage of development of cancer 1. fibrous 3. small cell 2. colloid 4. squamous 3. Types of endometrium giving rise to polyps 1. atrophic 2. functioning 3.
  4. Hyperplastic and dystrophic processes of the external genital organs and vagina
    Hyperplastic and dystrophic processes of the external genital organs and
  5. Diseases of the female genital organs and mammary glands. Cervical Diseases. UTERINE BODY DISEASES. Diseases of the fallopian tubes. DISEASES OF THE OVARIES. BREAST DISEASES
    Diseases of the female genital organs and mammary glands. Cervical Diseases. UTERINE BODY DISEASES. Diseases of the fallopian tubes. DISEASES OF THE OVARIES. MILK DISEASES
  6. Sexually transmitted diseases of the female genital organs
    One of the negative phenomena of our modernity is the rapid increase in the frequency and number of sexually transmitted diseases. This is facilitated by changes in the orientation of sexual behavior of young people, the widespread use of contraceptives, the expansion of international tourism, prostitution, the resistance of pathogens to antibacterial agents and the absence of etiopathogenetic
  7. Female genital inflammatory diseases
    Inflammatory diseases of the female genital organs (VZPO) occupy the first place in the structure of gynecological diseases. About 40% of gynecological patients in the hospital have VZPO. The cause of all inflammatory diseases of the genitals are microbes, which most often enter the body of a woman through sexual contact. Pathogens can also spread by the lymphogenous, hematogenous route,
  8. INFLAMMATORY DISEASES OF FEMALE GENITAL ORGANS
    The problem of inflammatory processes of the genitals has always been the focus of attention of obstetrician-gynecologists for the following reasons: • in frequency they occupy the first place in gynecology; • their consequences are very diverse and include various violations of the menstrual and reproductive functions (infertility, miscarriage, ectopic pregnancy), as well as general organ damage involving
  9. Malignant diseases of the female genital organs
    Female genital malignancies
  10. INFLAMMATORY DISEASES OF THE LOWER DEPARTMENT OF FEMALE GENITAL ORGANS
    Chlamydial infection - up to 60-70% of patients with VZNE are infected with chlamydia. It is transmitted only sexually. Has a lot to do with gonococci. Chlamydia - Gr (-) intracellular bacteria tropic to the cylindrical epithelium (cervical canal, fallopian tubes, bartholin gland ducts, urethra and paraurethral passages). The incubation period is 20-30 days. There is no bright clinic, initially there is a tendency to
  11. INFLAMMATORY DISEASES OF THE LOWER DEPARTMENT OF FEMALE GENITAL ORGANS
    Chlamydial infection - up to 60-70% of patients with VZNE are infected with chlamydia. It is transmitted only sexually. Has a lot to do with gonococci. Chlamydia - Gr (-) intracellular bacteria tropic to the cylindrical epithelium (cervical canal, fallopian tubes, bartholin gland ducts, urethra and paraurethral passages). The incubation period is 20-30 days. There is no bright clinic, initially there is a tendency to
  12. INFLAMMATORY DISEASES OF THE UPPER DEPARTMENT OF FEMALE GENITAL ORGANS.
    Acute salpingo-oophoritis (in first place in frequency). The infectious process passes to the ovary during ovulation, when after the release of the egg the wound surface is exposed, that is, the entrance gate to the infection. Clinic: pains of various nature and severity of the lower abdomen, the process is usually bilateral. Symptoms of intoxication (fever, chills, weakness, malaise, etc.).
  13. NON-SPECIFIC INFLAMMATORY DISEASES OF FEMALE GENITAL ORGANS
    Due to excessive reproduction of opportunistic flora (bacteroids, peptostreptococci, eubacteria, enterococci, E. coli, etc.), which under normal conditions does not cause symptoms
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