Аннотация
Цель работы – установление частот встречаемости клеток с аномалиями ядра в многослойном плоском неороговевающем (МПНЭ) и цилиндрическом эпителии (ЦЭ) шейки матки (ШМ) у жительниц г. Воронежа 3-х возрастных групп. Обследованы 60 женщин без гинекологической патологии. 1-ю группу составили 20 нерожавших женщин 17–19 лет, во 2-ю группу вошли 20 женщин в возрасте 20–30 лет с одними родами и в 3-ю группу — 20 женщин в возрасте 60–65 лет с двумя родами в анамнезе. Мазки высушивали на воздухе, фиксировали по Май-Грюнвальду, окрашивали по Романовскому. В МПНЭ ШМ выявлено 17 типов ядерных аберраций, в ЦЭ – 12. Впервые обнаружены микроядра и протрузии ядра в ЦЭ ШМ. Доли клеток МПНЭ с протрузиями, насечками, ядрами атипичной формы, перинуклеарными вакуолями, конденсацией хроматина, вакуолизацией ядра и суммарное количество клеток с аномалиями были выше у женщин из 3-й группы по сравнению с 1-й и 2-й группами, количество клеток с кариопикнозом в 3-й группе было минимальным. Только в группе 20–30-летних женщин были обнаружены клетки с несколькими протрузиями в ядре, липидными каплями и гранулами гликогена; число клеток с началом кариолизиса в этой группе превышало аналогичный показатель в 1-й и 3-й группах. В ЦЭ с увеличением возраста увеличилась доля клеток с кариопикнозом и снизилась — с краевой конденсацией хроматина и гранулами секрета. Во 2-й группе отмечено максимальное количество клеток с насечками. Суммарная доля клеток ЦЭ с аномалиями с возрастом не изменялась. Таким образом, МПНЭ ШМ менее стабилен с точки зрения поддержания цитогенетического гомеостаза, чем ЦЭ: обнаружено большее количество типов аномалий ядра и сильнее выражены возрастные изменения. Однако суммарная доля клеток ЦЭ с аберрациями у женщин из 1-й и 2-й групп была выше, чем МПНЭ. Требуется устанавливать отдельные нормы для разных возрастных групп и разных типов эпителия ШМ.
Annotation
The purpose of the work is to establish the frequency of occurrence of cells with nuclear anomalies in the stratified squamous non-keratinizing epithelium (SSnCE) and columnar epithelium (CE) of the cervix in Voronezh residents of 3 age groups. 60 women without gynecological pathology were examined. The 1st group consisted of 20 nulliparous women aged 17–19 years, the 2nd group included 20 women aged 20–30 years with one birth, and the 3rd group included 20 women aged 60–65 years with a history of two births. The smears were air dried, fixed according to May-Grunwald, and stained according to Romanovsky. 17 types of nuclear aberrations were identified in the SSnCE of the cervix, and 12 in the CE. Micronuclei and nuclear protrusions were discovered for the first time in the CE of the cervix. The proportion of SSnCE cells with protrusions, notches, atypically shaped nuclei, perinuclear vacuoles, chromatin condensation, nuclear vacuolization and the total number of cells with abnormalities were higher in women from group 3 compared to groups 1 and 2, the number of cells with karyopyknosis in group 3 was minimal. Only in the group of 20–30 year old women cells with several protrusions in the nucleus and with lipid droplets and glycogen granules were found; the number of cells with the onset of karyolysis in this group exceeded the same indicator in groups 1 and 3. In the CE, with increasing age, the proportion of cells with karyopyknosis increased and the proportion with marginal chromatin condensation and secretion granules decreased. In group 2, the maximum number of cells with notches was noted. The total proportion of CE cells with abnormalities did not change with age. Thus, cervical SSnCE is less stable from the point of view of maintaining cytogenetic homeostasis than CE: a greater number of types of nuclear anomalies were detected and age-related changes were more pronounced. However, the total proportion of CE cells with aberrations in women from groups 1 and 2 was higher than SSnCE. It is necessary to establish separate standards for different age groups and different types of cervical epithelium.
Key words: nuclear anomalies, stratified squamous non-keratinizing epithelium, normal values, columnar epithelium, cervix
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