Endometrial hyperplasia: without atypia and with atypia

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 18-24
Author(s):  
Maksim A. Sabantsev ◽  
Svetlana V. Shramko ◽  
Vladimir G. Levchenko ◽  
Oleg A. Volkov ◽  
Tatyana V. Tretyakova
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Research Methods ◽  
Endometrial Hyperplasia ◽  
Menopausal Hormone Therapy ◽  
Pubmed Database ◽  
Gynecological Diseases ◽  
Current Classification

The article analyzes and presents data for the last 70 years from the PubMed database on endometrial hyperplasia (EH), which is one of the leaders in the structure of gynecological diseases and the main predictor of endometrial cancer (EC). The chronicle of the EH classification is highlighted with a focus on changing the designation and relevance of adenomatous EH. It is shown how the current classification of EH, due to the fact that a large number of synonyms is limited by two options, allows to maximize the reproducibility of the diagnosis, improve the interaction of the obstetrician-gynecologist with the pathologist and reduce the treatment inefficiency. The results of modern studies on the prevalence and risk factors of EH and EC differ from previously accepted ones and destroy the Bohman triad. The risks of EH development with tamoxifen and menopausal hormone therapy are determined. The data of current research methods aimed at the diagnosis of EH and EC are indicated. The differences in etiopathogenesis, prevalence, diagnosis, risk factors for development and progression to the malignant process presented in the review represent two types of EH (without atypia and with atypia) as completely different endometrial diseases included in the same classification.

MENOPAUSAL HORMONOTHERAPY IN ONCOGYNECOLOGIC PATIENTS

2017 ◽  
Vol 63 (6) ◽  
pp. 843-854
Author(s):  
Olga Novikova ◽  
Yelena Ulrikh ◽  
V. Nosov ◽  
A. Charkhifalakyan
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Hormone Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Menopausal Hormone Therapy ◽  
Oncological Safety

There is presented the review of domestic and foreign references on the conserved oncological safety of the use of menopausal hormone therapy after treatment for endometrial cancer, cervical cancer, borderline and malignant ovarian tumors, various variants of sarcomas of the uterus, vulva and vaginal cancer. To the opinion of the authors the refusal to prescribe menopausal hormone therapy to patients with oncogynecologic diseases in the anamnesis is usually not justified, the category of patients, to whom hormone replacement therapy is contraindicated, is well described and mentioned in the text. In other cases sex hormones can be used to treat menopausal symptoms and improve the quality of life of patients.

scholarly journals Menopausal hormone therapy and mortality among endometrial cancer patients in the NIH-AARP Diet and Health Study

2015 ◽  
Vol 26 (8) ◽  
pp. 1055-1063 ◽  
Author(s):  
Ashley S. Felix ◽  
Hannah Arem ◽  
Britton Trabert ◽  
Gretchen L. Gierach ◽  
Yikyung Park ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Menopausal Hormone Therapy ◽  
Health Study

scholarly journals A proposal for a new classification of “unfavorable risk criteria” in patients with stage I endometrial cancer

2019 ◽  
Vol 29 (7) ◽  
pp. 1086-1093 ◽  
Author(s):  
Richard Li ◽  
Ashwin Shinde ◽  
Ernest Han ◽  
Stephen Lee ◽  
Sushil Beriwal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiation Therapy ◽  
Endometrial Cancer ◽  
Lymphovascular Invasion ◽  
Figo Stage ◽  
Stage I ◽  
Adjuvant Radiation ◽  
New Classification ◽  
Stage Ib

BackgroundRandomized trials describe differing sets of high–intermediate risk criteria.ObjectiveTo use the National Cancer Database to compare the impact of radiation therapy in patients with stage I endometrial cancer meeting different criteria, and define a classification of “unfavorable risk.”MethodsPatients with stage I endometrial cancer between January 2010 and December 2014 were identified in the National Cancer Database and stratified into two cohorts: (1) patients meeting Gynecologic Oncology Group (GOG)-99 criteria only for high–intermediate risk, but not Post-Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-1 criteria and (2) those meeting PORTEC-1 criteria only. High-risk stage I patients with both FIGO stage IB (under FIGO 2009 staging) and grade 3 disease were excluded. In each cohort, propensity score-matched survival analyses were performed. Based on these analyses, we propose a new classification of unfavorable risk. We then analyzed the association of adjuvant radiation with survival, stratified by this classification.ResultsWe identified 117,272 patients with stage I endometrial cancer. Of these, 11,207 patients met GOG-99 criteria only and 5,920 patients met PORTEC-1 criteria only. After propensity score matching, adjuvant radiation therapy improved survival (HR=0.73; 95% CI 0.60 to 0.89; p=0.002) in the GOG-99 only cohort. However, there was no benefit of adjuvant radiation (HR=0.89; 95% CI 0.69 to 1.14; p=0.355) in the PORTEC-1 only cohort. We, therefore, defined unfavorable risk stage I endometrial cancer as two or more of the following risk factors: lymphovascular invasion, age ≥70, grade 2–3 disease, and FIGO stage IB. Adjuvant radiation improved survival in stage I patients with adverse risk factors (HR=0.74; 95% CI 0.68 to 0.80; p<0.001), but not in other stage I patients (HR=1.02; 95% CI 0.91 to 1.15; p=0.710; p interaction <0.001).ConclusionOur study showed that adjuvant radiation was associated with an overall survival benefit in patients meeting GOG-99 criteria only; however, no survival benefit was seen in patients meeting PORTEC-1 criteria only. We propose a definition of unfavorable risk stage I endometrial cancer: ≥2 risk factors from among lymphovascular invasion, age ≥70, grade 2–3 disease, and FIGO stage IB disease.

scholarly journals Is estrogen plus progestin menopausal hormone therapy safe with respect to endometrial cancer risk?

2012 ◽  
Vol 132 (2) ◽  
pp. 417-426 ◽  
Author(s):  
Britton Trabert ◽  
Nicolas Wentzensen ◽  
Hannah P. Yang ◽  
Mark E. Sherman ◽  
Albert R. Hollenbeck ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cancer Risk ◽  
Hormone Therapy ◽  
Menopausal Hormone Therapy ◽  
Endometrial Cancer Risk ◽  
Estrogen Plus Progestin

scholarly journals Hormone therapy after endometrial cancer.

2004 ◽  
Vol 11 (2) ◽  
pp. 305-314 ◽  
Author(s):  
A O Mueck ◽  
H Seeger
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Endometrial Carcinoma ◽  
Low Dose ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Climacteric Complaints

Endometrial carcinoma is listed under the absolute contraindications to hormone therapy (HT). According to current opinion, HT after stage I or II is still considered an option, and continuous combined oestrogen/progestogen replacement therapy (CCEPT) would be recommended. However, up to now, only observational studies have been put forward. Although none of these studies have established an increased rate of recurrence or mortality, alternatives such as phytopreparations and tibolone, or particular psychotherapeutic drugs, such as venlafaxine, should be considered for the relief of climacteric complaints. Progestogen-only therapy (PT) particularly has been considered. However, the currently discussed possible progestogen effects regarding an increased risk of breast cancer have to be taken into account. Indeed, the wider discussion about the gestagen effects regarding the risk of breast cancer is to be considered. Generally, after hysterectomy, at least for patients with cardiovascular risk factors, the preference today is to use low-dose oestrogen therapy (patches or gels) instead of CCEPT, and this is also now recommended for patients after endometrial cancer. This is to be noted because of the risk factors for endometrial carcinoma, such as hypertension, obesity, polycystic ovary syndrome (PCO) and diabetes mellitus. However, each form of HT should be only exceptionally recommended, and the patients must be informed about the risks that exist and the use of alternatives.

scholarly journals Risk factors of endometrial cancer in patients with endometrial hyperplasia: implication for clinical treatments

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Zhao ◽  
Yongting Hu ◽  
Yanan Zhao ◽  
Dongmei Chen ◽  
Tingfeng Fang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Clinical Characteristics ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Regression Analyses ◽  
Logistics Regression ◽  
Prevention And Treatment ◽  
Retrospective Study Design ◽  
Clinical Prevention

Abstract Background Endometrial hyperplasia (EH) is commonly-seen in the patients with endometrial cancer (EC), we aimed to evaluated the risk factors of EC in patients with EH, to provide evidence to the clinical prevention and treatment of EC. Methods This study was a retrospective study design. EH patients confirmed by pathological examinations and treated with hysterectomy in our hospital from June 1, 2018 to February 28, 2021 were included. The clinical characteristics of EC and no-EC patients were compared and analyzed. Logistics regression analyses were conducted to evaluate the risk factors of EC in patients with EH. Results A total of 228 EH patients were included, the incidence of EC in the EH patients was 31.58%. There were significant differences in the age, BMI, diabetes, hypertension and pathology of EH between EC and no EC groups (all P < 0.05), no significant differences in the hyperlipidemia, preoperative CA125, number of deliveries, menopause and endometrial thickness between EC and no EC groups were found (all P > 0.05). Logistic regression analyses indicated that age > 50 y (OR 3.064, 95% CI 1.945–5.931), BMI ≥ 25 kg/m2 (OR 2.705, 95% CI 1.121–3.889), diabetes (OR 3.049, 95% CI 1.781–5.114), hypertension (OR 2.725, 95% CI 1.108–3.431) and severe hyperplasia (OR 3.181, 95% CI 1.496–4.228) were the risk factors of EC in patients with EH (all P < 0.05). Conclusions The risk of EC in EH patients is high, especially for those patients with age > 50 y, BMI ≥ 25 kg/m2, diabetes, hypertension and severe hyperplasia, special attentions should be paid for occurrence of EC and early diagnosis and early treatment are needed for those patients.

Menopausal Hormone Therapy and Cardiovascular Risk: Where are we Now?

2019 ◽  
Vol 17 (6) ◽  
pp. 564-572 ◽  
Author(s):  
Panagiotis Anagnostis ◽  
Stavroula A. Paschou ◽  
Niki Katsiki ◽  
Dimitrios Krikidis ◽  
Irene Lambrinoudaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hormone Therapy ◽  
Premature Death ◽  
Fold Increase ◽  
Menopausal Hormone Therapy ◽  
Favorable Effect ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Age At Menopause ◽  
Early Postmenopausal Women

Transition to menopause is associated with an increase in cardiovascular disease (CVD) risk, mainly attributed to lipid and glucose metabolism dysregulation, as well as to body fat redistribution, leading to abdominal obesity. Indeed, epidemiological evidence suggests that both early menopause (EM, defined as age at menopause <45 years) and premature ovarian insufficiency (POI, defined as age at menopause <40 years) are associated with 1.5-2-fold increase in CVD risk. Menopausal hormone therapy (MHT) exerts a favorable effect on CVD risk factors (with subtle differences regarding oestrogen dose, route of administration, monotherapy or combination with progestogen and type of progestogen). Concerning CVD morbidity and mortality, most studies have shown a beneficial effect of MHT in women at early menopausal age (<10 years since the final menstrual period) or younger than 60 years. MHT is strongly recommended in women with EM and POI, as these women, if left untreated, are at risk of CVD, osteoporosis, dementia, depression and premature death. MHT has also a favorable benefit/ risk profile in perimenopausal and early postmenopausal women, provided that the patient is not at a high CVD risk (as assessed by 10-year calculation tools). Transdermal oestrogens have a lower risk of thrombosis compared with oral regimens. Concerning progestogens, natural progesterone and dydrogesterone have a neutral effect on CVD risk factors. In any case, the decision for MHT should be individualized, tailored according to the symptoms, patient preference and the risk of CVD, thrombotic episodes and breast cancer.

Vaginal bleeding during menopause hormone therapy. Is it always endometrial cancer? How to choose the appropriate tactics for examination and management of patients?

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 37-43
Author(s):  
Anna E. Protasova ◽  
Irina A. Solntseva ◽  
Ekaterina N. Vandeeva
Keyword(s):  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Genital Tract ◽  
Vaginal Bleeding ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menopausal Hormone Therapy ◽  
Modern Analysis ◽  
Menopause Hormone Therapy ◽  
Postmenopausal Vaginal Bleeding

The article provides an overview of the possible causes of bleeding from the genital tract in peri- and postmenopausal women. The correct approach to patients with abnormal uterine bleeding during menopausal hormone therapy is described. A modern analysis of data on the diagnosis and treatment of postmenopausal vaginal bleeding against the background of menopausal hormone therapy was carried out. The modern possibilities of endometrial diagnostics and treatment are shown.

MYCOBACTERIUM ABSCESSUS COMPLEX REPRESENTATIVES IN PATIENTS WITH BRONCHOPULMONARY PATHOLOGY: PREVALENCE, PECULIARITIES OF CULTIVATION AND IDENTIFICATION

2020 ◽  
Vol 65 (5) ◽  
pp. 316-320
Author(s):  
K. R. Kalimulina ◽  
Danir Damirovich Ismatullin ◽  
A. V. Lyamin ◽  
O. V. Kondratenko ◽  
A. V. Kozlov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Russian Federation ◽  
Mycobacterium Abscessus ◽  
Nutrient Media ◽  
Mycobacterium Abscessus Complex ◽  
Modern Methods ◽  
Current Classification ◽  
Screening Study ◽  
The Russian Federation

More and more publications appear in the modern literature on the increase in the prevalence of non-tuberculous mycobacteria (NTMs), in particular, representatives of M. chelonae / Mycobacterium abscessus complex (MABSc). The paper presents data on the current classification of M. chelonae / Mycobacterium abscessus complex and its main representatives. The main data on the possible sources and ways of infection of MABSc patients in hospital are presented. The main features of cultivation on various nutrient media and their possible identification using modern methods are also indicated. The main risk factors for the development of mycobacteriosis in patients and the possible clinical picture are described. The prevalence of MABSc representatives in the structure of non-tuberculous mycobacteria isolated from clinical material from 483 patients from the Samara region was assessed for examination for tuberculosis, and the prevalence from 933 patients with cystic fibrosis (CF) from 55 regions of the Russian Federation from 2016 to 2019 was estimated. In total, as a result of the study, 316 NTM strains (65.4%) were isolated and identified in the first group of patients. M.abscessus was isolated and identified 10 strains and 5 strains - M.chelonae, which amounted to 3.2% and 1.6%, respectively, of all NTMs. In general, MABSc representatives were isolated in 3.1% of the examined patients. As a result of a screening study of patients with CF, 14194 microorganism strains from 933 patients were isolated and identified. Altogether M. abscessus was isolated and confirmed from 14 patients of different ages. Thus, the prevalence of MABSc among the examined patients with CF in the Russian Federation was 1.5%.

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