Endometrial hyperplasia, diagnosis. Clinical, paraclinical exam and management

Factors associated with unopposed estrogenic stimulation such as obesity, exogenous hormone use endometrial hyperplasia are related to the development of the most common form of endometrial carcinoma, that is, the endometroid subtype. We selected a group of patients diagnosed with endometrial hyperp...

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Published inRevista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi Vol. 114; no. 2; p. 445
Main Authors Pangal, Alexandra, Costăchescu, Gh, Aldea, Marie Jeanne
Format Journal Article
LanguageRomanian
Published Romania 01.04.2010
Subjects
Adult
Aged
Biopsy
Body Mass Index
Endometrial Hyperplasia - complications
Endometrial Hyperplasia - diagnostic imaging
Endometrial Hyperplasia - etiology
Endometrial Hyperplasia - pathology
Endometrial Hyperplasia - surgery
Endosonography
Female
Humans
Hysterectomy
Hysteroscopy
Immunohistochemistry
Middle Aged
Obesity - complications
Retrospective Studies
Risk Factors
Treatment Outcome
Uterine Hemorrhage - etiology
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Summary:Factors associated with unopposed estrogenic stimulation such as obesity, exogenous hormone use endometrial hyperplasia are related to the development of the most common form of endometrial carcinoma, that is, the endometroid subtype. We selected a group of patients diagnosed with endometrial hyperplasia by endometrial biopsy and histopathological examination. The main complaint in all cases was abnormal uterine bleeding. All patients had gynecological examination, vaginal ultrasound, hysteroscopy endometrial biopsy or D&C. 32 patients had also immunohistochemical staining for Ki67, EGF, ER, PGR. Cases with ages between 24-67 years were classified as: 100 simple hyperplasia, 10 complex hyperplasia, 43 atypical simple hyperplasia, 7 atypical complex hyperplasia. PR were 40-60% at all forms of hyperplasia, E2R were 30-40% in simple hyperplasia without atypia and 50-70% in complex hyperplasia without atypia. Correlation between immunohistochemical expression of E2R, PGR, Ki-67, EGF and body mass revealed an high immunohistochemical expression of E2R and Ki-67 in patients with hyperplasia without atypia and a low expression and high reactivity of EGF in cases with high body mass. Vaginal ultrasound and hysteroscopy are efficacious completion for histopathological diagnosis. We recommend an age/risk appropriate screening to detect risk factors and early disease in the asymptomatic patients.
ISSN:0048-7848