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CNAA / Theses / 2006 / June /

Rolul patologiei genitale şi extragenitale în riscul apariţiei hiperplaziilor dishormonale ale glandelor mamare


Author: Mihail Surguci
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2006
Scientific adviser: Valentin Friptu
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Nadejda Godoroja
doctor habilitat, Public Medical Sanitary Intitution Institute of Oncology
Institution:
Scientific council:

Status

The thesis was presented on the 20 June, 2006
Approved by NCAA on the 28 September, 2006

Abstract

Adobe PDF document0.38 Mb / in romanian

Thesis

CZU 618.19-007.61

Adobe PDF document 0.76 Mb / in romanian
116 pages


Keywords

dishormonal hyperplasia of mammary glands, genital affections, extra-genital disease, enterolactone

Summary

There where examined 1297 women with the age between 16 to 79 from the rural area with the purpose of determining the FR of HDGM, the women where divided into two groups: the main lot – 335 patients with HDGM and the witness lot – 962 women without HDGM. The investigation includes: passport data, genetic anamneses, the reproductive function properties, the utilization of special methods of investigation to appreciate the character of function modifications and the pathologic processes in GM, genital organs and some extra-genital organs (thyroid gland, hepatic-pancreatic-bilear system and the excretory system), the determination of enterolactone form sanguine plasma using the TR-FIA method of four groups of women: 1) actually healthy (n=14); 2) with HDGM associations, genital and extra/genital affections (n=35); 3) with the association of genital and extra-genital affections which weren’t administered fitoestrogen (n=20); 4) with the association of genital and extra-genital affections witch were administered firoestrogen - capsules with in oil with a doses of 0,33 g (by 2 capsules 3 times per day during 3 months) (n=20).

The study results statistic procession had been accomplished by the SPSS statistic programme. For the comparison of discreet variables the χ2 (Pearson) with the correction of Yates method and the exact method of Fisher had been applied. The comparison of mean variables was made by the T Student test or nonparametric tests. Statistic significant were considered the differences with the bilateral value P<0,05.

The frequency of HDGM in rural women population constitutes 25,8%. The diffuse MFC is diagnosed in 10,3% cases, MFC with localization tendency – in 3,8% cases, MFC nodosis - in 9,8% cases, macro cysts on the base of MFC – in 0,5% cases and mixed form – in 1,4% cases. The frequency of HDGM increases with the age, reaching the maximum for the women of 36-45 years (30,8%) and subsequently decreasing till the age of 66 and more (6,1%). The HDGM are considered statistic significant more frequent for the women of reproductive age (27,4%), with intercultural character of work (32,5%), nulipar (26,2%), multipar (25-28%), with 14-15 years age of menarche (28,8%), with 3-10 abortions in antecedents (32,7%), without sexual relations (27,5%), with deregulated menstrual rhythm (32,3%).

The genital organs chronic affections are more frequent diagnosed in women with HDGM: 74,3% in women from LB and 67,3% in women from LM (P<0,05). The gynecological affections were diagnosed with a statistic precision more frequent in intellectual and working women, married women, of reproductive age women with deregulated menstrual rhythm, women with 1-10 abortion in antecedents, with 15 years of menarche, with beginning of sexual relations from the age of 30 and without sexual relations, multieven women from LB, in comparison with LM.

The extra-genital affections, in general, is the in both study groups: 99,4% in LB and 97,9% in LM (P>0,05). At the same time, extra-genital affections were diagnosed with statistic precision more frequent in women from LB, having the first menarche 15 years before, with deregulated menstrual rhythm, with the beginning of sexual relations at 20-25 years. The pathology of thyroid gland was statistically significant diagnosed more frequent in women from LB (19,7%), in comparison with LM (6,0%).

The association of gynecological affections and extra-genital pathology is diagnosed with a statistic precision more frequent in women from LB with HDGM, in comparison with witness lot without HGDM (73,7% and 66,6%, respective; P<0,05). The association of these affections was diagnosed with a statistic precision more frequent in intellectual and working women, married women, of reproductive age with deregulated menstrual rhythm, and women with 1-10 abortions in antecedents, from the main lot.

The inflammatory affections and/or genital organs hyperplasic and tumour affections associate with hepatic-pancreatic-bilear system affections, thyroid gland and kidneys affections are statistically significant appreciated more frequent in patients from LB with HDGM, in comparison with the patients without HDGM from LM.

The enterolactone level in the sanguine serum is statistically significant higher in actually healthy women and women with genital and extra-genital associated affections, treated with fitoestrogen (capsule with in oil), in comparison with the group of women LB with the HDGM association, genital and extra-genital affections and the group of women with the association of genital and extra-genital affections from LM traditionally treated.