EVALUATION OF ENDOMETRIAL Bcl-2 EXPRESSION AND Ki-67 PROLIFERATIVE INDEX IN INFERTILE PATIENTS WITH AND WITHOUT POLYCYSTIC OVARY SYNDROME

Dilay Karademir; Akın Usta; Eren Altun

TR EN

POLİKİSTİK OVER SENDROMU OLAN VE OLMAYAN İNFERTİL OLGULARDA ENDOMETRİAL Bcl-2 EKSPRESYONU VE Ki-67 PROLİFERATİF İNDEKSİNİN DEĞERLENDİRİLMESİ

Bu makalenin ilk hali 31 Mart 2023 tarihinde yayımlandı. http://dergipark.org.tr/tr/pub/cmj/article/1250217

Öz

Amaç: Polikistik over sendromu (PKOS) üreme çağındaki kadınlarda görülen en sık infertilite nedenidir. Bu çalışmanın amacı; PKOS olan ve olmayan infertil hastalarda endometrial Bcl-2ve Ki-67 değerlerini biyokimyasal parametreler eşliğinde karşılaştırmaktır. Yöntem: Çalışmaya PKOS teşhisi konulan 27 infertil hasta ve PKOS kriterlerine uymayan 28 infertil hasta dahil edildi. Çalışmadan dışlanma kriterleri; kişinin sigara kullanması, pelvik enfeksiyon bulgusu, transvajinal ultrasonografide endometrial polip, submüköz myom vb. saptanması, hipofizer yetmezlik, hiperprolaktinemi, konjenital adrenal hiperplazisi olmak, adneksiyal cerrahi geçirmiş olmak ve infertiliteye sebep olacak erkek faktörü bulunmaktır. Tüm bireylerin yaş, infertilite süresi, vücut- kitle indeksi (VKİ), bel-kalça oranı (BKO), hirsutizm skoru, kan basınçları, total testesteron, trigliserit, total kolesterol, LDL, HDL değerleri, HOMA-IR ve hs-CRP değerleri not edildi. Patoloji uzmanı tarafından Bcl-2ve Ki-67 düzeyleri değerlendirildi. Bulgular: PKOS’lu infertil olgularda VKİ, BKO, total testosteron seviyesini, kan basıncını, total kolesterol değerini, HOMA-IR ve hs-CRP değerlerini belirgin yüksek bulduk. Ayrıca Ki-67 ve Bcl-2 değerinin PKOS’lu infertil olgularda endometriyal hücrelerde kontrol grubuna oranla daha yüksek olduğunu bulduk. Sonuç: Ki-67 ve Bcl-2 değerleri, PKOS’lu olgularda artarak, apopitozisin gerçekleşmesini engeller ve uygun endometriyal ortam oluşmasını engellerek de embriyonun implantasyon sürecini kısıtlar. Bu durum PKOS’lu olgularda infertilite ve tekrarlayan gebelik kayıplarına neden olabilmektedir. Bu soruna artmış östrojen aktivitesi sebep olabilir. PKOS’un tedavisinde, östrojen salınımını düzenleyen, özellikle GnRH salınımını düzenleyici ajanlar üzerine çalışmalar yapılmasına ihtiyaç duyulduğu ve tedavinin bu hedef üzerine şekillenmesi gerektiği kanaatindeyiz.

Anahtar Kelimeler

EVALUATION OF ENDOMETRIAL Bcl-2 EXPRESSION AND Ki-67 PROLIFERATIVE INDEX IN INFERTILE PATIENTS WITH AND WITHOUT POLYCYSTIC OVARY SYNDROME

Bu makalenin ilk hali 31 Mart 2023 tarihinde yayımlandı. http://dergipark.org.tr/tr/pub/cmj/article/1250217

Düzeltme Notu

"EVALUATION OF ENDOMETRIAL Bcl-2 EXPRESSION AND Ki-67 PROLIFERATIVE INDEX IN INFERTILE PATIENTS WITH AND WITHOUT POLYCYSTIC OVARY SYNDROME" isimli makale araştırma makalesi olarak başvurmuş ve o şekilde değerlendirilmiştir. Fakat mizanpaj esansında PDF dosyasında yapılan hatadan dolayı makale türü "Araştırma Makalesi" olarak güncellenmiştir.

Abstract

Objective: In women of reproductive age, polycystic ovary syndrome (PCOS) is the most prevalent cause of infertility. The purpose of this study is to compare the Bcl-2 and Ki-67 values between infertile patients with and without PCOS. Material and methods: The study included twenty-seven infertile patients diagnosed with PCOS and another twenty-eight infertile patients who did not meet the criteria for PCOS. Smoking, pelvic infection symptoms, endometrial polyps and submucosal myomas during a transvaginal ultrasound, pituitary insufficiency, hyperprolactinemia, congenital adrenal hyperplasia, having had adnexal surgery and having a male factor that will result in infertility are all considered exclusion criteria. All patients' data were collected, including age, the length of their infertility, body mass index (BMI), waist-to-hip ratio (WHR), hirsutism score, blood pressure, total testosterone, triglyceride, total cholesterol, LDL, and HDL values, as well as Homa-IR and Hs-CRP readings. The pathology specialist in the examples evaluated Bcl-2 and Ki-67 levels. Results: We found that BMI, WHR, total testosterone level, blood pressure, total cholesterol, HOMA-IR, and hs-CRP values were significantly higher in infertile cases with PCOS. We also found that the Ki-67 and Bcl-2 values were higher in endometrial cells in sterile PCOS cases than in the control group. Conclusions: Ki-67 and Bcl-2 levels rise in PCOS patients, preventing apoptosis, limiting the formation of a suitable endometrial environment, and preventing embryo implantation. PCOS patients may frequently experience infertility and recurrent pregnancy losses. The cause of this problem may be the increased activity of estrogen. The primary treatment for PCOS will depend on further investigation into the variables affecting estrogen synthesis and GnRH release. The care plan should be built around this goal.

Keywords

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Düzeltme

Yazarlar

Dilay Karademir ^*
0000-0002-9813-4255
Türkiye

Akın Usta
0000-0001-8973-4374
Türkiye

Eren Altun
0000-0001-9110-8364
Türkiye

Yayımlanma Tarihi

8 Mayıs 2023

Gönderilme Tarihi

12 Şubat 2023

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2023 Cilt: 45 Sayı: 1

IZ

https://izlik.org/JA92JK83HC

Kaynak Göster

RIS / Bibtex

AMA

1.Karademir D, Usta A, Altun E. EVALUATION OF ENDOMETRIAL Bcl-2 EXPRESSION AND Ki-67 PROLIFERATIVE INDEX IN INFERTILE PATIENTS WITH AND WITHOUT POLYCYSTIC OVARY SYNDROME. CMJ. 2023;45(1):87-95. https://izlik.org/JA92JK83HC