Georgian Scientists/ . 6 N 2, 2024 93 Georgian Scientists Vol. 6 Issue 2, 2024 https://doi.org/10.52340/gs.2024.06.02.12 1; 2; 3; 4; 5 1 Phd ; 2 ; , ; 3 ; 4 Phd ; ; 5 , ; , . , , . , . , (FFPE) 315 n=45; n=45; n=45; n=45; n=45; n=45; n=45;). , , , , , . Georgian Scientists/ . 6 N 2, 2024 94 , , . P16 , . : ; ; ; P16; , . , , , , p16- , , in situ.1 , . , .2,3 , . .4 .5 , , , , . , , , . , Georgian Scientists/ . 6 N 2, 2024 95 , . , , , .6,7 , , . , p16 , . Ki67- , p53 . , BCL2- PAX2- . , , . , , . , . ( ), . , , . , . p53- .8 , , p53- , . . , Ki67- , ( ) .9,10 . , Georgian Scientists/ . 6 N 2, 2024 96 , 5%- , Ki67 . . , . .11 , 2019-2023 . , (FFPE) 315 . 45 - ; 45 - ; 45 - ; 45 - ; 45 - ; 45 - 45 - (H&E) , QuPath- . . . : /ER - Clone: 6F11 Leica Georgian Scientists/ . 6 N 2, 2024 97 /PR - Clone: 16 Leica Ki67 (PA0230 clone K2, Leica) - ; BCL2 (bcl-2/100/D5, Leica) - D1/Cyclin D1- 6066478 Leica NovolinkTM Max Polymer Detection System. H&E ( ; .). : Spearman rank test- Mann-Whitney Kruskal-Wallis . 95%- .P <0.05 . SPSS statistical software V29.0- . (70.0±1,0) (50,3±1,3). (30,2±0,9). , , (22,4±1,9). Georgian Scientists/ . 6 N 2, 2024 98 1. 1) , , IHC, X200; 2) , , IHC, X200; 3) , , IHC, X200; 4) , , IHC, X200; (41,4±1,5), . (25.0±1,3). . , (25,3±1,3). . (40,3±1,4). (20,6±0,6). Georgian Scientists/ . 6 N 2, 2024 99 , , (32,4±1,5). (15,2±1,8). ER PR 70.0±1,0 65,6±1,8 60,4±0,8 71,8±1,1 40,5±1,3 53,8±0,6 41,4±1,5 53,2±0,9 50,3±1,3 62,4±1,8 30,2±0,9 22,4±1,9 50,2±1,5 62,3±0,2 45,3±0,9 55,1±0,3 30,4±1,0 41,6±1,4 30,2±1,1 55,4±1,1 0 0 25.0±1,3 25,3±1,3 80,2±1,5 75,2±0,7 80,7±1,7 80,2±1,4 70,3±1,5 61,3±1,3 50,1±0,5 65,6±3,1 40,3±1,4 32,4±1,5 20,6±0,6 15,2±1,8 1. Georgian Scientists/ . 6 N 2, 2024 100 2- , Ki67- (24,2±0,7), (18,5±1,1) (18,3±1,0). BCL2- (16,8±0,9), (8,7±1,1), (25,7±1,4). Cyclin D1- (23,9±1,2). p16- (23,2±1,1). (6,2±1,7). Ki67- (27,7±1,5), . BCL2 (8,6±1,1) (35,2±3,8), . Cyclin D1- BCL2- , (32,4±1,6). . p16- (22,5±2,2). , (14,8±0,8). Georgian Scientists/ . 6 N 2, 2024 101 2. 1) Ki67, , IHC, X200; 2) Ki67, , IHC, X200; 3) BCL2, , IHC, X200; 4) BCL2, , IHC, X200; , Ki67- , (10,3±1,5), (55,7±1,8). BCL2- , (5,7±0,9) , (42.0±1,8). Cyclin D1- Ki67- BCL2- (8,8±0,5) (61,6±1,9). p16 . (6,7±0,8) (24,1±2,4). (12,4±1,7). Georgian Scientists/ . 6 N 2, 2024 102 3. 1) Cyclin D1, , IHC, X200; 2) Cyclin D1, , IHC, X200; 3) P16, , IHC, X200; 4) P16, , IHC, X200; Ki67 BCL2 Cyclin D1 P16 12,6±0,9 12,1±0,8 5,2±0,5 8,7±1,3 11,4±0,7 15,3±1,2 12,8±0,3 6,2±0,4 14,2±1,0 16,8±0,9 11,8±0,7 12,4±1,1 Georgian Scientists/ . 6 N 2, 2024 103 24,2±0,7 8,7±1,1 15,2±1,0 16,7±0,8 18,5±1,1 32,7±1,2 22,7±1,7 23,2±1,1 18,3±1,0 25,7±1,4 23,9±1,2 6,2±1,7 15,3±04 8,6±1,1 7,3±0,6 15,8±0,4 16,2±0,5 21,3±0,1 12,2±1,4 11,4±1,3 18,1±0,8 22,5±0,7 15,2±1,2 18,4±0,7 28,3±1,6 22,4±1,7 24,3±1,9 22,5±2,2 0 0 0 0 27,7±1,5 35,2±3,8 32,4±1,6 14,8±0,8 10,3±1,5 5,7±0,9 8,8±0,5 0 12,4±0,6 16,3±0,6 14,2±1,1 0 14,8±0,3 18,6±1,3 11,5±2,0 0 32,8±0,8 25,3±1,9 25,3±0,7 6,7±0,8 35.0±0,9 28,3±1,2 44,2±1,4 24,1±2,4 55,7±1,8 42.0±1,8 61,6±1,9 12,4±1,7 2. Ki67- , BCL2- , Cyclin D1- p16- Georgian Scientists/ . 6 N 2, 2024 104 10.2- , 30- . 20,4- . 34,9- . 29,8- , 39,9- . 8,7- , 19,9- . 10- , . . 9,6- 4,4- . 9,7- , 12,9- . 8,4- , 25,1- . 7,5- , , 19,7- . 12,4- , 10,2- . 30- . Georgian Scientists/ . 6 N 2, 2024 105 . , 7,2- , 10,1- . 1. Ki67- 2,3- , 5- . 1- , 3,8- . 0,6- , 3,3- . , 8,6- , 4,5- . 16,5- , . . 37,4- , 28- . Georgian Scientists/ . 6 N 2, 2024 106 , BCL2- 6,4- , 2,9- . 1- , 5- . , 3,9- . 16,6- , 2,9- . 4,4- , . , 16,3- , 6,8- . Cyclin D1- 3,6- , 1,5- . 1,4- , 2- . , 3,7- . 10,1- , , . 21,5- . 37,2- , 28,7- . , P16- . 10- , 15,7- Georgian Scientists/ . 6 N 2, 2024 107 . 0,9- , . . , P16- 6,2- , 2,4- . 2. Ki67- , BCL2- , Cyclin D1- p16- , , , , , . , . , . Georgian Scientists/ . 6 N 2, 2024 108 , , . Ki67- , , , , . BCL2- . , , . P16 , . : 1. Little, L. & Stewart, C. J. R. Cyclin D1 immunoreactivity in normal endocervix and diagnostic value in reactive and neoplastic endocervical lesions. Mod Pathol 23, 611–618 (2010). 2. D’Angelo, E. et al. Atypical Endometrial Hyperplasia, Low-grade: ‘much ADO about Nothing’. American Journal of Surgical Pathology 45, 988–996 (2021). 3. Lax, S. F. [Precursor lesions of endometrial carcinoma]. Pathologe 40, 13–20 (2019). 4. McCluggage, W. G. Mullerian adenosarcoma of the female genital tract. Adv Anat Pathol 17, 122–129 (2010). 5. Stringfellow, H. F. & Elliot, V. J. Endometrial metaplasia. Diagn Histopathol 23, 303–310 (2017). 6. Nicolae, A., Preda, O. & Nogales, F. F. Endometrial metaplasias and reactive changes: A spectrum of altered differentiation. J Clin Pathol 64, 97–106 (2011). Georgian Scientists/ . 6 N 2, 2024 109 7. Travaglino, A. et al. Endometrial Metaplastic/Reactive Changes Coexistent with Endometrial Hyperplasia and Carcinoma: A Morphological and Immunohistochemical Study. Diagnostics (Basel) 12, (2021). 8. Hou, J. Y., McAndrew, T. C., Goldberg, G. L., Whitney, K. & Shahabi, S. A clinical and pathologic comparison between stage-matched endometrial intraepithelial carcinoma and uterine serous carcinoma: Is there a difference? Reproductive Sciences 21, 532–537 (2014). 9. Apostolou, G. et al. Cytodiagnosis of endometrial carcinoma and hyperplasia on imprint smears with additional immunocytochemistry using Ki-67 and p53 biomarkers. Cytopathology 25, 86–94 (2014). 10. Apostolou, G. et al. Utility of Ki-67, p53, Bcl-2, and Cox-2 biomarkers for low-grade endometrial cancer and disordered proliferative/benign hyperplastic endometrium by imprint cytology. Diagn Cytopathol 42, 134–142 (2014). 11. Simon, R. A. et al. Tubal metaplasia of the endometrium with cytologic atypia: analysis of p53, Ki-67, TERT, and long-term follow-up. Modern Pathology 2011 24:9 24, 1254–1261 (2011). Georgian Scientists/ . 6 N 2, 2024 110 Features of hormone receptor expression and proliferative-apoptotic characteristics in endometrial ciliary/tubal metaplasia T. Turashvili1; G. Tevdorashvili2; N. Tevzadze3; Sh.Kepuladze4; G. Burkadze5; 1MD, Phd Student at Tbilisi State medical University; Email: teonaturashvili87@yahoo.com; 2Professor at Tbilisi State Medical University, Gynecology and Obstetrics; Emai: g.tevdorashvili@tsmu.edu; 3Resident in Clinical Pathology at Tbilisi State medical University E-mail: niniatevzadze1@gmail.com; 4Phd Student at Tbilisi State medical University; AP/CP pathologist; MD E-mail: shota.kepuladze@gmail.com; https://orcid.org/0000-0002-5919-5581; 5Professor at Tbilisi State Medical University, Head of the Department of Molecular pathology; E-mail: burkadze@yahoo.com g.burkadze@tsmu.edu, https://orcid.org/0000-0002-5028-4537 Abstact Metaplasia is an adaptive process in which one tissue is transformed into another tissue that is functionally and morphologically different. The most common type of metaplasia in the endometrium is ciliary/tubal metaplasia, which is also common in the cervix, where it is most often located in the transition zone. Ciliary metaplasia of the endometrium is often described in combination with excessive estrogen expression, and its association with simple and complex hyperplasia and highly differentiated adenocarcinoma is also worth noting. Overall, the study included a total of 315 unfixed formalin-fixed and paraffin-embedded (FFPE) cases (normal endometrium n=45; endometrial polyp n=45; simple endometrial hyperplasia n=45; complex endometrial hyperplasia n=45; atypical endometrial hyperplasia n=45). ; endometrioid carcinoma n=45; serous carcinoma n=45;). As can be seen from the data of our studies, ciliary metaplasia, as well as atypical ciliary metaplasia, is characterized by a different expression of estrogen receptors from the main research groups, which indicates hormone sensitivity independent of the main research nosology, which can also be evaluated as a justification for the existence of ciliary metaplasia independent of the main nosologies. As can be seen from the results, ciliary metaplasias show a different proliferative activity from the main study group, which should be taken into account in the algorithm for the evaluation of precancerous processes and tumors of endometrial hyperplasias. P16 can be used as an additional marker of possible progression of endometrial atypical hyperplasia to carcinoma in combination with other parameters. Key words: Endometrial metaplasia; proliferation; Ciliary metaplasia; P16;