Korpus Luteum Varlığının Rutin Ovariohisterektomi Uygulanan Klinik Olarak Sağlıklı Dişi Kedilerde Endometriyal Hiperplazi İçin Bir Risk Faktörü Olarak Değerlendirilmesi

Öz

Bu prospektif kesitsel çalışmada, rutin ovariohisterektomi geçiren klinik olarak sağlıklı dişi kedilerde korpus luteum (CL) varlığının subklinik endometriyal hiperplazi ile ilişkili olup olmadığı araştırılmıştır. Rutin cerrahi amacıyla getirilen, 13–27 aylık, ASA I sınıfında yer alan elli dişi kedi çalışmaya dahil edilmiştir. Ovariohisterektomi sonrasında uterus ve ovaryumlar histopatolojik incelemeye tabi tutulmuş; CL ve kistler dahil tüm ovaryum yapıları ile uterin lezyonlar sistematik şekilde kaydedilmiştir. Uterus ve ovaryum bulgularının prevalansı tanımlayıcı istatistiklerle belirlenmiş; CL varlığı (luteal faz progesteron maruziyetinin dolaylı göstergesi olarak) ile endometriyal hiperplazi (EH) arasındaki ilişki Fisher’ın kesin testi kullanılarak, olasılık oranı (OR) ve %95 güven aralığı (GA) hesaplanarak değerlendirilmiştir. Üreme ile ilgili herhangi bir klinik şikayet bulunmamasına rağmen kedilerin %36’sında (18/50) EH, %20’sinde (10/50) kistik endometriyal hiperplazi (CEH) tespit edilmiş; ayrıca %12’sinde hafif endometritis ve %8’inde diğer hiperplastik lezyonlar belirlenmiştir. Ovaryum kistleri, çoğunlukla foliküler tipte olup, kedilerin %34’ünde saptanmış; CL ise %48’inde (24/50) gözlenmiştir. CL bulunan kedilerde EH prevalansı CL bulunmayanlara göre anlamlı derecede daha yüksek olup (%54.2’ye karşı %19.2; p=0.014), bu fark OR 4.96 (GA %95, 1.4–17.6) ile luteal fazdaki hayvanların EH geliştirme olasılığının yaklaşık beş kat arttığını göstermektedir. Bu bulgular, progesteron ilişkili endometriyal değişikliklerin genç ve klinik olarak sağlıklı dişi kedilerde yaygın ve büyük ölçüde subklinik olduğunu ortaya koymakta; CL varlığını erken uterin yeniden şekillenme açısından klinik olarak önemli bir risk faktörü olarak desteklemektedir. Bu lezyonların uzun dönem klinik öneminin daha kapsamlı araştırılmasına ihtiyaç vardır.

Anahtar Kelimeler

• Endometriyal hiperplazi
• Kedi
• Kistik endometriyal hiperplazi
• Korpus luteum
• Ovariohisterektomi
• Progesteron

Corpus Luteum Presence as a Risk Factor for Endometrial Hyperplasia in Clinically Healthy Female Cats Undergoing Routine Ovariohysterectomy

Öz

In this prospective cross-sectional study, we investigated whether corpus luteum (CL) presence is associated with subclinical endometrial hyperplasia in clinically healthy female cats undergoing elective ovariohysterectomy. Fifty intact female cats (13-27 months, ASA I) presented for routine surgery were enrolled. Following ovariohysterectomy, uteri and ovaries were subjected to full-thickness histopathological examination, and uterine lesions and ovarian structures, including CL and cysts, were systematically recorded. Descriptive statistics were used to determine the prevalence of uterine and ovarian findings, and the association between CL presence (as a proxy for luteal-phase progesterone exposure) and endometrial hyperplasia (EH) was evaluated using Fisher’s exact test with calculation of odds ratio (OR) and 95% confidence interval (CI). Despite the absence of reproductive complaints, EH and cystic endometrial hyperplasia (CEH) were identified in 36% (18/50) and 20% (10/50) of female cats, respectively, while mild endometritis and other hyperplastic lesions were detected in 12% and 8%. Ovarian cysts, predominantly follicular, were present in 34% of cats, and CLs were observed in 48% (24/50). Female cats with CL had a significantly higher prevalence of EH than those without CL (54.2% vs 19.2%; p=0.014), corresponding to an OR of 4.96 (95% CI 1.4-17.6), indicating that luteal-phase animals were nearly five times more likely to exhibit EH. These findings demonstrate that progesterone-associated endometrial changes are common and largely subclinical in young, clinically healthy female cats and support CL presence as a clinically relevant risk factor for early uterine remodeling, warranting further investigation into the long-term significance of these lesions.

Anahtar Kelimeler

• Corpus luteum
• Cystic endometrial hyperplasia
• Endometrial hyperplasia
• Feline
• Ovariohysterectomy
• Progesterone

Kaynakça

1. Agudelo CF (2005). Cystic endometrial hyperplasia-pyometra complex in cats: A review. Vet Q, 27(4), 173–182.
2. Binder C, Aurich C, Reifinger M, Aurich J (2019). Spontaneous ovulation in cats—uterine findings and correlations with animal weight and age. Anim Reprod Sci, 209, 106167.
3. Binder C, Reifinger M, Aurich J, Aurich C (2021). Histopathological findings in the uteri and ovaries of clinically healthy cats presented for routine spaying. J Feline Med Surg, 23(8), 770–776.
4. Bukowska B, Jurczak A, Tobolski D, Janowski T (2020). Prevalence of subclinical uterine pathologies diagnosed by biopsy, cytology and bacteriology in cyclic bitches. Pol J Vet Sci, 23, 595–603.
5. De Bosschere H, Ducatelle R, Vermeirsch H, Simoens P, Coryn M (2002). Estrogen-α and progesterone receptor expression in cystic endometrial hyperplasia and pyometra in the bitch. Anim Reprod Sci, 70, 251–259.
6. Enginler SÖ, Şenünver A (2011). The effects of progesterone hormone applications used for suppression of estrus on mammary glands in queens. Kafkas Univ Vet Fak Derg, 17, 277–284.
7. Johnson AK (2022). Normal feline reproduction: The queen. J Feline Med Surg, 24, 204–211.
8. Keskin A, Yılmazbas G, Yılmaz R, Ozyigit MO, Gümen A (2009). Pathological abnormalities after long-term administration of medroxyprogesterone acetate in a queen. J Feline Med Surg, 11, 518–521.

9. Martí A, Serrano A, Pastor J et al. (2021). Endometrial status in queens evaluated by histopathology findings and two cytological techniques: low-volume uterine lavage and uterine swabbing. Animals, 11, 88.
10. Maya-Pulgarin D, Gonzalez-Dominguez MS, Aranzazu-Taborda D et al. (2017). Histopathologic findings in uteri and ovaries from clinically healthy dogs at elective ovariohysterectomy: a cross-sectional study. J Vet Sci, 18, 407–414.
11. Nascimento AEJ, Santos LC, Santos BR et al. (2023). Estrogen and progesterone receptors and antioxidant enzymes are expressed differently in the uterus of domestic cats during the estrous cycle. Theriogenology, 203, 1–10.
12. Okur DT, Ozdemir S, Aydin S et al. (2025). Effects of melatonin implants on uterine inflammation and ovarian progesterone receptor expression in female cats: a histopathological and molecular analysis. Theriogenology, 238, 117368.
13. Schlafer DH, Gifford AT (2008). Cystic endometrial hyperplasia, pseudo-placentational endometrial hyperplasia, and other cystic conditions of the canine and feline uterus. Theriogenology, 70(3), 349-358.
14. Siemieniuch MJ, Bowolaksono A, Skarzynski DJ, Okuda K (2010). Ovarian steroids regulate prostaglandin secretion in the feline endometrium. Anim Reprod Sci, 120(1-4), 142-150.
15. Woźna-Wysocka M, Rybska M, Błaszak B et al. (2021). Morphological changes in bitches’ endometrium affected by cystic endometrial hyperplasia–pyometra complex-the value of histopathological examination. BMC Vet Res, 17(1), 174.
16. Yaseen AA, Kareem DA, Waheed Z, Fahad TA (2022). Histopathological study of some abnormalities of infertility in queens. Basrah J Vet Res, 21(S1), 131-140.
17. Younis M, Mohammed FF, Abu-Seida AM, Ragab RS, Gohar HM (2014). Ultrasonography and pathological evaluation of cystic endometrial hyperplasia–pyometra complex in bitches and queens with related ovarian alterations. Global Vet, 13(1), 60-67.