medigraphic.com
ISSN 1561-3062 (Electronic)

2014, Number 3

<< Back Next >>

Revista Cubana de Obstetricia y Ginecología 2014; 40 (3)

Characterization of endometrial hyperplasia at 'Prof. Eusebio Hernández' Gynecobstetric Teaching Hospital

Perera BOM, Molina PL, Torres TJ

Language: Spanish
References: 51
Page: 307-318
PDF size: 83.84 Kb.


ABSTRACT

Introduction: endometrial hyperplasia is a proliferation of endometrial glands in size and irregular shape, caused by excessive exposure to estrogen.
Objective: to characterize the endometrial hyperplasia in patients at Eusebio Hernández Hospital in 2011.
Method: a descriptive study was conducted. 2842 pathology reports were reviewed in the Department of Pathology, at ''Profesor Eusebio Hernández" Gynecobstetric Hospital in Marianao, Havana from January 1st to December 31st, 2011. 1269 of them were for endometrial biopsies obtained by curettage.
Results: 154 endometrial biopsies (12.1 %) had the diagnosis of endometrial hyperplasia. The age range of diagnosis was more frequent for women between 41 and 50 years and the highest percentage of patients (84.4 %) were diagnosed with simple hyperplasia without atypia; while 7.1 % of the cases showed atypia. The associated risk factor was obesity in 46.1 % of cases. Ultrasound had positivity in patients with atypical endometrial 90.9 % and 100% hysteroscopy. Hormone therapy was used in 67.5 % of patients and surgical treatment was used in all patients with cellular atypia.
Conclusions: there was a predominance of endometrial hyperplasia without atypia in women aged between 41 and 60 and with low parity and a low occurrence of atypical hyperplasia.


REFERENCES

  1. Hiperplasia endometrial. Patología estructural y funcional. En: Robbins.España:Mc Graw-Hill Interamericana;1999:1104-8.

  2. Lesiones malignas del útero. En: Rigol O. Obstetricia y ginecología. La Habana: Ciencias Médicas; 2004:307-8.

  3. Ronnett BM, Kurman RJ. Precursor lesions of endometrial carcinoma. In: Kurman RJ, ed. Blaustein’s Pathology of the Female Genital Tract, 5th ed. New York: Springer-Verlag, 2002:467-500.

  4. Kummar V, Abbas A, Fausto N. Robbins and Cotran Pathologic Basis of Disease, 7ma. ed. Elsevier 2004;22:1088-108.

  5. Álvarez de los Heros J, Monte Mercado J, Pérez Ortega A. Lesiones Premalignas de Endometrio. Hiperplasia. Tratado de Ginecología, Obstetricia y Medicina de la Reproducción. Editorial Médica: Panamericana, Tomo 2, S.E.G.O. 2003:1587-93.

  6. Martínez PL, Atero MD, Bosch JM. ¿Hiperplasia endometrial atípica o adenocarcinoma de endometrio? Un reto. Prog Obstet Ginecol 2008;51(10):605-9.

  7. Montgomery BE, Daum GS, Dunton CJ. Endometrial Hyperplasia: A Review. Obstet Gynecol Survey 2004;59(5):368-75.

  8. Kresowik J, Ryan GL, Van Voorhis BJ. Progresión of Atypical Endometrial hyperplasia to Adenocarcinoma Obstetrics and Gynecology. Endoscopía Ginecológica.111(2), Part 2, February 2008:547-9.

  9. Lethaby A, Farquhar C, Sarkis A, Roberts H, Jepson R, Barlow D. Terapia de reemplazo hormonal en mujeres postmenopáusicas: hiperplasia endometrial y sangrado irregular. En: La Biblioteca Cochrane Plus, 2008:(4). Disponible en: http://www.update-software.com

  10. Flint E. Hiperplasia Endometrial y Técnicas de Ablación de Endometrio.Perú:Sociedad Peruana de Obstetricia y Ginecología;2006-2010. Disponible en: http://www.interactivastudio.com

  11. Maillet M. Departamento de Patología Universidad de Valencia, curso de Posgrado en Citopatología clínica. La Habana; Ciencias Médicas; 2000.

  12. American College of Obstetricians and Gynecologists (ACOG) practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer. Obstet Gynecol. 2005;106:413-25.

  13. The evaluation of abnormal uterine bleeding. Lippincot Williams and Wilkins. Clin Obstet Gynecol. 2005;48(2):258-73.

  14. Cáncer endometrial. Revista de Menopausia (en línea). (Acceso: 13 marzo 2007). Disponible en: http://www.encolombia.com/menovol6200-riesgos2.htm

  15. Brun JL, André G, Descat E, Creux H, Vigier J, Dallay DJ. Methods and efficacy of medical and surgical treatment of non functional menorrhagia Gynecol Obstet Biol Reprod. 2008 Dec;37(Suppl 8):368-83.

  16. Méndez García M, Torres Hernández R, LLanes Vivó A, Rodríguez Hernández V. Hiperplasia endometrial. Revista de Ciencias Médicas La Habana 2011;17(2).

  17. Barahona S, Mere J. Hiperplasia endometrial. Experiencia en el Hospital Nacional Arzobispo Loayza. Rev Per Ginecol Obstet. 2006;52(3):89-99.

  18. García Ayala E, Cárdenas Mastrascusa L, Sandoval Martínez D, Mayorga Anaya H. Hiperplasia endometrial. Análisis de serie de casos diagnosticados en biopsia endometrial. Rev Chil Obstet Ginecol 2010;75(3):146-52.

  19. Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of ‘untreated’ hyperplasia in 170 patients. Cancer 1985;56:403-12.

  20. Horn LC, Schnurrbusch U, Bilek K, Hentschel B, Einenkel J. Risk of progression in complex and atypical endometrial hyperplasia: clinicopathologic analysis in cases with and without progestogen treatment. Int J Gynecol Cancer 2004;14:348-53.

  21. Horn LC, Meinel A, Handzel R, Einenkel J. Histopathology of endometrial hyperplasia and endometrial carcinoma: An update. Ann Diagn Pathol 2007;11:297-311.

  22. Tratado de Ginecología, Obstetricia y Medicina de la Reproducción. Panamericana, Tomo 2. Sociedad Española de Ginecología y Obstetricia. 2003;1587-93.

  23. Hammond R, Johnson J. Endometrial hyperplasia. Current Obstetrics and Gynecology. 2004;14:99-103.

  24. Tabata T, Yamawaki T, Yabana T, Ida M, Nishimura K, Nose Y. Natural history of endometrial hyperplasia. Study of 77 patients. Arch Gynecol Obstet. 2001;265:85-8.

  25. Katsanis WA, Shields LB. Immune recognition of endometrial tumour antigens induced by multiparity. Gynecol Oncol. 1998;70(1):33-9.

  26. Randall TC, Kurman RJ. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol. 1997;90:434-40.

  27. Galcerán J. Carcinoma de endometrio: incidencia y mortalidad. Ginecol Obstet Clin. 2003;4(1):8-10.

  28. Petridou E, Belechri M, Dessypris N, Koukoulomatis P, Diakomanolis E, Spanos E, et al. Leptin and body mass Gynecol Obstet Fertil. 2002 Mar;30(3):244-51.

  29. Brun JL, Belaisch J, Rivel J, Hocké C. Endometrial hyperplasias resistant to progestins: alternatives to traditional treatments. Ann Nutrit Metabol 2002;46:147-51.

  30. Ivanov S, Kovachev E, Tsonev A, Abbud A. Modern tendencies in treatment of atypical glandular hyperplasia our and foreign experience. Akush Ginekol (Sofia). PubMed. 2010;49(2):47-9.

  31. Mazur MT. Endometrial hyperplasia/adenocarcinoma: A conventional approach. Ann Diagn Pathol. 2005;9:174-81.

  32. Lacey JV Jr, Ioffe OB, Ronnett BM, Rush BB, Richesson DA, et al. Absolute Risk of Endometrial Carcinoma During 20-Year Follow-Up Among Women With. Endometrial Hyperplasia J Clin Oncol. 2010 February 10;28(5):788-92.

  33. Epplein M, Reed SD, Voigt LF, Newton KM, Holt VL, Weiss NS. Risk of complex and atypical endometrial hyperplasia in relation to anthropometric measures and reproductive history. Am J Epidemiol. 2008;168:563-70.

  34. Lindahl B, Willen R. Spontaneous endometrial hyperplasia. A prospective, 5 year follow-up of 246 patients after abrasio only, including 380 patients followed-up for 2 years. Anticancer Res. 1994;14:2141-6.

  35. Randall LM. Management of disfunctional uterine blleding during adelescence I Luisiana. Med Soc. 1988;110:160.

  36. Carreras R, Mancebo G. Obesidad y Cáncer de Endometrio. Med Clin (Barc). 2007;128(5):176-7.

  37. Sweet MG, Schmidt-Dalton TA, Weiss PM, Madsen KP. Evaluation and management of abnormal uterine bleeding in premenopausal women. American Family Phisician. 2012 Jan 1;85(1):35-43.

  38. Ricci E, Moroni S, Parazzini F. Risk factors for endometrial hyperplasia: Results from a case-control study. Int J Gynecol Cancer. 2002;12:257-60.

  39. Bergós C. Cáncer de endometrio ¿Qué pruebas diagnósticas hemos de realizar antes de la cirugía? Ginecol Obstet Clín. 2003;4(1):15-22.

  40. The evaluation of abnormal uterine bleeding. Lippincot Williams and Wilkins. Clin Obstet Gynecol. 2005;48(2):258-73.

  41. Gao WL, Zhang LP, Feng LM. Comparative study of transvaginal ultrasonographic and diagnostic hysteroscopic findings in postmenopausal breast cancer patients treated with tamoxifen. Chin Med J. (Engl). 2011 Aug;124(15):2335-9.

  42. Gunderson CC, Fader AN, Carson KA, Bristow RE. Oncologic and Reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 Adenocarcinoma: A systematic review. Gynecol Oncol. Jan 11 2012;125(2).

  43. Penner KR, Dorigo O, Aoyama C, Ostrzega N, Balzer BL, Rao J, et al. Predictors of resolution of complex atypical hyperplasia or grade 1 endometrial adenocarcinoma in premenopausal women treated with progestin therapy. Gynecol Oncol. 2011 Nov(10):27-32.

  44. Reed SD, Newton KM, Garcia RL, Allison KH, Voigt LF, et al. Complex Hyperplasia With and Without Atypia: Clinical Outcomes and Implications of Progestin Therapy Obstet Gynecol. 2010 August;116(2 Pt 1):365-73.

  45. Kurt Christopher G. Significance of Concurrent Endometrial Cancer in Women With a Preoperative Diagnosis of Atypical Endometrial Hyperplasia. J Obstet Gynaecol Can. 2008 October;30(10):896-901.

  46. Koloszar S, Pal Z, Kereszturi A, Vajda G, Pal A, Daru J. Effects of aromatase inhibitor on menopausal hyperplasia in a case of obesity. Climacteric. 2012 Feb;15(1):93-4.

  47. Reed SD. Complex hyperplasia with and without atypia: Clinical outcomes and implications of progestin therapy. Annual American Association for Cancer Research, April 18-22, 2009.

  48. Furness S, Roberts H, Marjoribanks J, Lethaby A, Hickey M, Farquhar C. Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. PubMed. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD000402.

  49. Sitruk-Ware R. The levonorgestrel intrauterine system for use in peri- and postmenopausal women. Contraception. 2007 Jun;75(6 Suppl):155-60.

  50. Kresowik J, Ryan GL, Van Voorhis BJ. Progression of atypical endometrial hyperplasia to adenocarcinoma despite intrauterine progesterone treatment with the levonorgestrel-releasing intrauterine system. Obstet Gynecol. 2008 Feb;111(2 Pt 2):547-9.

  51. Yu M, Shen K, Yang JX, Huang HF, Wu M, Pan LY, et al. Outcome analysis of conservative treatment of well-differentiated endometrial adenocarcinoma and severe atypical hyperplasia in young women. Zhonghua Fu Chan KeZaZhi. 2006 Apr;41(4):242-5.




2020     |     www.medigraphic.com