Preview

Fundamental and Clinical Medicine

Advanced search

Predicting the risk of malignisation of endometrial hyperplasia in reproductive age

https://doi.org/10.23946/2500-0764-2020-5-1-57-63

Abstract

Aim. Atypical endometrial hyperplasia (AEH) is a strong predictor of endometrial cancer, which is responsible for 80% of endometrial malignancies; out of all patients AEH, 10-50% are further diagnosed with endometrial cancer. Here we developed an algorithm for calculating the risk of AEH ma-lignisation in women of reproductive age.

Materials and Methods. Our study included 143 women of reproductive age with a histologically confirmed endometrial hyperplasia. Patients were further divided into those having AEH and non-atypical endometrial hyperplasia. Control group included 56 women with abnormal uterine bleeding without endometrial hyperplasia, adeno-myosis, uterine fibroids, and cancer. We then performed binary logistic regression model for the identification of significant risk factors of AEH malignisation.

Results. Among the significant risk factors were miRNA levels (miR-210, miR-18a, miR-221, miR-222), pyruvate kinase M2, pelvic inflammatory disease (OR = 7.73), adenomyosis (OR = 3.34), benign mammary dysplasia (OR = 3.21), and uterine fibroids in conjunction with adenomyosis (OR = 8.34).

Conclusion. Our results show that every third patient with AEH has a risk of its malignisation to endometrial cancer. We also developed an algorithm for calculating the individual risk of such event.

About the Authors

I. M. Ordiyants
Peoples’ Friendship University of Russia
Russian Federation

Dr. Irina M. Ordiyants - MD, DSc, Professor, Department of Obstetrics, Gynecology.

6, Miklukho-Maklaya Street, Moscow, Moscow, 117198



A. A. Kuular
Peoples’ Friendship University of Russia
Russian Federation

Dr. Aida A. Kuular - MD, PhD Student, Department of Obstetrics, Gynecology.

6, Miklukho-Maklaya Street, Moscow, Moscow, 117198



A. A. Yamurzina
Peoples’ Friendship University of Russia
Russian Federation

Dr. Anastasia A. Yamurzina - MD, PhD Student, Department of Obstetrics, Gynecology.

6, Miklukho-Maklaya Street, Moscow, Moscow, 117198


D. S. Novginov
Peoples’ Friendship University of Russia
Russian Federation

Dr. Dmitry S. Novginov - MD, Assistant Professor, Department of Obstetrics, Gynecology.

6, Miklukho-Maklaya Street, Moscow, Moscow, 117198



References

1. Tabakman YuYu, Solopova AG, Bishtavi AKh, Idrisova LE. Endometrial hyperplasia: controversia issues of pathogenesis and therapy. Obstetrics, gynecology and reproduction. 2016;10(3):5-10 (In Russ.). https://doi.org/10.17749/2313-7347.2016.10.2.005-010

2. Savlieva GM, Suchich GT, Serov VN, Radzinsky VE, Manuchin IB, editors. Gynecology. national guidelines. Moscow: GEOTAR-Media Publ; 2017:303-362 (In Russ.).

3. Gallos ID, Alazzam M, Clark TJ, Faraj R, Rosenthal A, Smith PP, Gupta JK. Management of endometrial hyperplasia. Green-top Guideline No. 67. RCOG/BSGE Joint Guideline; 2016 Accessed January 2019. https://www.rcog.org.uk/globalassets/documents/guidelines/green-top-guidelines/gtg_67_endometrial_hyperplasia.pdf

4. Venediktova MG, Dobrokhotova YuE. Onkoginekologiya v praktike ginekologa. Moscow: GEOTAR-MediaPubl; 2017. (In Russ.).

5. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics 2014. CA A Cancer Journal for Clinicians. 2014;64(1):9-29. https://doi.org/10.3322/caac.21208

6. Tabakman YuYu, Solopova AG, Bishtavi AKh, Idrisova LE. Endometrial precancer: definition of concepts, tactics Akusherst-vo, Ginekologiya, Reproduktsiya. 2016;10(2):32-36 (In Russ.). https://doi.org/10.17749/2313-7347.2016.10.2.032-036

7. Carlson MJ, Thiel KW, Leslie KK. Past, present, and future of hormonal therapy in recurrent endometrial cancer. Int J Womens Health. 2014;6:429-435. https://doi.org/10.2147/IJWH.S40942

8. Chandra V, Kim JJ, Benbrook DM, Dwivedi A, Rai R. Therapeutic options for management of endometrial hyperplasia. J Gynecol Oncol. 2016;27:712-749. https://doi.org/10,3802/jgo.2016.27.e8

9. Dumanovskaya MR, Chernukha GE, Burmenskaya OV, Donnikov AE, Trofimov DYu. Probability of neoplastic transformation in different types of endometrial hyperplasia. Obstetrics and gynecology.2013;8:56-62 (In Russ.).

10. Unanyan AL, Sidorova IS, Kogan EA, Baburin DV. Clinicopathogenetic features of hyperplastic endometrial processes in women of perimenopausal age. RMJ. Medical Review. 2018;2(1-1):67-71 (In Russ.).

11. Dobrokhotova YuE, Saprykina LV. Endometrial hyperplasia. Moscow: GEOTAR-Media Publ; 2018. (In Russ.).

12. Litta P, Bartolucci C, Saccardi C, Codroma A, Fabris A, Borgato S, Conte L. Atypical endometrial lesions: hysteroscopic resection as an alternative to hysterectomy. Eur J Gynaecol Oncol. 2013;34(1):51-53.

13. Owings RA, Quick CM. Endometrial intraepithelial neoplasia. Arch Pathol Lab Med. 2014;138(4):484-91. https://doi.org/10.5858/arpa.2012-0709-RA

14. Chernukha GE, Dumanovska-ya MR, Burmenskaya OV, Shubina ES, Kogan EА, Trofimov DYu. Expression of apoptosis-regulatory genes in different endometrial hyperplasia types and endometrioid carcinoma. Obstetrics and gynecology. 2013;(1):63-69 (In Russ.).

15. Luo L, Luo B, Zheng Y, Zhang H, Li J, Sidell N. Levonorgestrel-releasing intrauterine system for atypical endometrial hyperplasia. Cochrane Database SystRev. 2013;(6):CD009458. https://doi.org/10.1002/14651858.CD009458.pub2

16. Gornykh OA, Tabakman YuYu, Bishtavi AKh, Gogoladze KhT, Chabrov AM, Kostin AYu. The results of surgical treatment of atypical endometrial hyperplasia. Russian Journal of Human Reproduction.2014;1:20-23. (In Russ.).


Review

For citations:


Ordiyants I.M., Kuular A.A., Yamurzina A.A., Novginov D.S. Predicting the risk of malignisation of endometrial hyperplasia in reproductive age. Fundamental and Clinical Medicine. 2020;5(1):57-63. (In Russ.) https://doi.org/10.23946/2500-0764-2020-5-1-57-63

Views: 837


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2500-0764 (Print)
ISSN 2542-0941 (Online)