scholarly journals Neoplasia intraepitelial endometrial: una lesión precursora de cáncer de endometrio

2021 ◽  
Vol 81 (01) ◽  
pp. 75-85
Author(s):  
Ernesto Lara ◽  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Intraepithelial Neoplasia ◽  
Atypical Hyperplasia ◽  
Classification Systems ◽  
World Health ◽  
Type I ◽  
Female Population ◽  
Typical Sequence ◽  
Endometrial Intraepithelial Neoplasia

Endometrial cancer represents worldwide the sixth most common malignant pathology in the female population, the endometroid type constitutes the most common form, usually developed from a typical sequence of endometrial hyperplasia secondary to sustained exposure to unopposed estrogens balanced by progestogens. Different classification systems for endometrial hyperplasia have been described, the most recent, published by the World Health Organization in 2014, proposes two categories: 1) hyperplasia without atypia, and 2) atypical hyperplasia or endometrial intraepithelial neoplasia. This classification avoids confusion due to the different terms in use and reflects a better understanding of the pathology behavior. Atypical hyperplasia or endometrial intraepithelial neoplasia is considered a precursor lesion to endometrial carcinoma type I. Health professionals must handle standardized terminology, accurately diagnose this entity, and ensure proper treatment of it. Keywords: Endometrial intraepithelial neoplasia, Endometrial hyperplasia, Atypical hyperplasia, Endometrial cancer.

Congruence Between 1994 WHO Classification of Endometrial Hyperplasia and Endometrial Intraepithelial Neoplasia System

2019 ◽  
Vol 153 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Antonio Travaglino ◽  
Antonio Raffone ◽  
Gabriele Saccone ◽  
Massimo Mascolo ◽  
Maurizio Guida ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Meta Analysis ◽  
Intraepithelial Neoplasia ◽  
Atypical Hyperplasia ◽  
Classification Systems ◽  
World Health ◽  
Endometrial Intraepithelial Neoplasia ◽  
Subgroup Analyses ◽  
Health Organization

Abstract Objectives To assess congruence between World Health Organization (WHO) 1994 and endometrial intraepithelial neoplasia (EIN) classification systems of endometrial hyperplasia. Methods Systematic review and meta-analysis were performed by searching electronic databases for studies that classified endometrial hyperplasia according to both WHO 1994 and EIN systems. Congruence was based on the rate of specimens classified as EIN in WHO categories, which should be virtually 0.000 in nonatypical hyperplasia (NAH) and 1.000 in atypical hyperplasia (AH). Subgroup analyses were performed based on architecture complexity. Results Eight studies with 1,352 hyperplasias were included. Congruence with EIN criteria was fair in NAH (0.241) and moderate in AH (0.815). Subgroup analyses of NAH showed high congruence in simple NAH (0.065), null in complex NAH (0.517), null in simple AH (0.148), and high in complex AH (0.901). Conclusions WHO 1994 system is not congruent with the EIN system and cannot be directly translated into a dual classification.

COMPARISON OF ENDOMETRIAL INTRAEPITHELIAL NEOPLASIA & WHO CLASSIFIED ENDOMETRIAL HYPERPLASIA IN PREDICTING THE RISK OF PROGRESSION TO ENDOMETRIAL CARCINOMA

2021 ◽  
pp. 59-61
Author(s):  
Bansi Kavar ◽  
Neeru Dave
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Intraepithelial Neoplasia ◽  
Atypical Hyperplasia ◽  
Cytological Atypia ◽  
Endometrial Intraepithelial Neoplasia ◽  
Risk Of Progression ◽  
Classi Cation ◽  
Cation System ◽  
Sampling Procedures

Background: Endometrial hyperplasia is the precursor lesion of most endometrial cancers of endometrioid type. The most commonly used classication system for endometrial hyperplasia is WHO 1994 classication system in which architecture disruption and cytological atypia are used to identify four types of endometrial hyperplasia including simple or complex hyperplasia with or without atypia. Newer EIN diagnosis by cytological atypia is of great consideration for the progression to endometrial cancer. Material And Methods: The study consists of 100 cases of WHO classied endometrial hyperplasia for period of 4 yrs from 2015 to 2019. Type of sampling procedures- dilation & curettage, endometrial biopsy and fractional curettage. Objective: 1. To discuss revised criteria for recognition of endometrial intraepithelial neoplasia (EIN). 2. To nd out the sensitivity of endometrial intraepithelial neoplasia (EIN) classication in predicting the risk of malignancy. Results: This study consists of 100 cases of endometrial hyperplasia. Patients were mostly postmenopausal & presented with abnormal vaginal bleeding. From WHO classied endometrial lesions, 2 out of 35 cases of simple typical hyperplasia, 10 out of 14 cases of complex typical hyperplasia,12 out of 20 cases of simple atypical hyperplasia and 20 out of 21 cases of complex atypical hyperplasia were reclassied as EI N. Conclusion: To estimate the risk of progression to carcinoma and guide clinical management, the histo-pathologic diagnosis of endometrial hyperplastic lesion is very important, specially the diagnosis of EIN lesions. EIN carries a much greater risk of progression to endometrial cancer than other WHO classied endometrial hyperplasia.

Possible Role of PTEN expression in discriminating Benign Endometrial hyperplasia from Atypical Hyperplasia/Endometrial Intraepithelial Neoplasia in a series of Egyptian Patients

2021 ◽  
Vol 17 ◽  
Author(s):  
Nevine I. Ramzy ◽  
Wael S. Ibrahiam ◽  
Hanan H.M. Ali ◽  
Mona M.A. Akle ◽  
Sara E. Khalifa
Keyword(s):  
Endometrial Hyperplasia ◽  
Intraepithelial Neoplasia ◽  
Atypical Hyperplasia ◽  
Pten Expression ◽  
Histological Evaluation ◽  
Type I ◽  
Pten Protein ◽  
Endometrial Intraepithelial Neoplasia ◽  
Egyptian Patients

Background: Endometrial hyperplasia represents a heterogeneous group of lesions in response to the unopposed growth-promoting action of estrogen. WHO classified endometrial hyperplastic lesions into Benign Hyperplasia (BH) and atypical hyperplasia/ endometrial intraepithelial neoplasia AH/EIN. Phosphatase and tensin homolog (PTEN) is one of the earliest and most common genetic abnormalities detected in endometrioid adenocarcinoma (type I) and even in its precursors. This study aimed at histological evaluation of hyperplastic endometrial lesions according to WHO 2014 and investigating the role of PTEN expression in highlighting the precancerous group (AH/EIN). Patient and Method: This study included a series of 70 Egyptian patients suffered from hyperplastic endometrial lesions. They were previously diagnosed according to WHO1994 schema simple endometrial hyperplasia without atypia (n=18), simple endometrial hyperplasia with atypia (n=2), complex hyperplasia without atypia (n=25), complex hyperplasia with atypia (n=5) and hyperplastic endometrial polyps (n=20). Results: Cases were histologically re-evaluated according to WHO 2014 classification; BH (62 cases) and eight cases of AH/EIN. A significant difference in PTEN expression (regarding percentage and intensity of staining) in relation to histopathological diagnosis was detected (P-value 0.02 and <0.05, respectively). The sensitivity and specificity of the absence of diffuse PTEN protein expression (>50%) to detect AH/EIN were 100% and 77.4%, respectively. Conclusion: Diffuse, dim or loss of immunohistochemical expression of PTEN protein is significantly correlated with the new WHO classification segregation of AH/EIN as precancerous lesions. However, further studies are recommended to confirm this association.

Endometrial hyperplasia (Clinical lecture)

2016 ◽  
pp. 10-18 ◽  
Author(s):  
I.B. Vovk ◽  
◽  
N.Е. Gorban ◽  
O.Ju. Borysiuk ◽  
◽  
...  
Keyword(s):  
Key Words ◽  
Hormonal Therapy ◽  
Endometrial Hyperplasia ◽  
Intraepithelial Neoplasia ◽  
Diagnosis And Treatment ◽  
Pathogenetic Mechanisms ◽  
Endometrial Intraepithelial Neoplasia ◽  
Mechanisms Of Development ◽  
Clinical Lecture

In clinical lecture presents modern views of endometrial hyperplasia in terms of practitioner gynecologist. The problems of classification, pathogenetic mechanisms of development of endometrial hyperplasia. Particular attention is paid to modern approaches to diagnosis and treatment of endometrial hyperplasia. Key words: hyperplasia, endometrium, classification, endometrial hyperplasia, endometrial intraepithelial neoplasia, hormonal therapy.

scholarly journals Molecular Classification to Prognosticate Response in Medically Managed Endometrial Cancers and Endometrial Intraepithelial Neoplasia

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2847
Author(s):  
Allison M. Puechl ◽  
Daniel Spinosa ◽  
Andrew Berchuck ◽  
Angeles Alvarez Secord ◽  
Kerry E. Drury ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Single Gene ◽  
Intraepithelial Neoplasia ◽  
Molecular Classification ◽  
Definitive Treatment ◽  
Time To Progression ◽  
Endometrial Intraepithelial Neoplasia ◽  
Definitive Therapy ◽  
Patients At Risk ◽  
Endometrial Cancers

Background: The aim of this study was to evaluate whether molecular classification prognosticates treatment response in women with endometrial cancers and endometrial intraepithelial neoplasia (EIN) treated with levonorgestrel intrauterine system (LNG-IUS). Methods: Patients treated with LNG-IUS for endometrial cancer or EIN from 2013 to 2018 were evaluated. Using immunohistochemistry and single gene sequencing of POLE, patients were classified into four groups as per the Proactive Molecular Risk Classifier for Endometrial cancer (ProMisE): POLE-mutated, mismatch repair-deficient (MMRd), p53 wild type (p53wt), and p53-abnormal (p53abn). Groups were assessed relative to the primary outcome of progression or receipt of definitive treatment. Results: Fifty-eight subjects with endometrioid endometrial cancer or EIN treated with LNG-IUS were included. Of these, 22 subjects (37.9%) had endometrial cancer and 36 subjects (62.1%) had EIN. Per the ProMisE algorithm, 44 patients (75.9%) were classified as p53wt, 6 (10.3%) as MMRd, 4 (6.9%) as p53abn, and 4 (6.9%) as POLE-mutated. Of the 58 patients, 11 (19.0%) progressed or opted for definitive therapy. Median time to progression or definitive therapy was 7.5 months, with p53abn tumors having the shortest time to progression or definitive therapy. Conclusions: Molecular classification of endometrial cancer and EIN prior to management with LNG-IUS is feasible and may predict patients at risk of progression.

Sign in / Sign up

Export Citation Format

Share Document