Endometrial hyperplasia: current approaches to diagnosis and treatment. Literature review and own experience
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TLDR
Endometrial hyperplasia value was higher in postmenopausal women with metabolic syndrome compared to patients with normal weight, overweight and obesity and the combination of hyperproliferative processes and apoptosis inhibition if there is metabolic syndrome confirms the existing data on the predominance of the apoptotic inhibition over proliferation in the formation of endometrial diseases in the post menopausal period.Abstract:
Purpose of the study: to examine the morphological and immunohistochemical features of the endometrium in postmenopausal women with uterine bleeding, depending on body weight and metabolic syndrome.Materials and methods. The study included 114 women with postmenopausal uterine bleeding. Women were divided into 3 groups. Group I included 41 patients with overweight and obesity class I–II, group II – 43 women with metabolic syndrome, group III (control) consisted of 30 patients with normal body weight. Hysteroscopy with morphological analysis of biopsied material was performed for all patients of groups I and III and 41 patients of group II. Pathohistological and immunohistochemical analysis were used to diagnose endometrial pathology. The level of cell proliferation in the endometrium was assessed by immunohistochemical analysis using monoclonal antibodies for Ki-67 expression; antiapoptotic activity was determined by the Bcl-2 and COX-2 expression.Results. Endometrial pathology was diagnosed in 94.74% of women. Endometrial polyps in the structure of the identified pathologyprevailed in group I and control group III (82.93% and 83.33%, respectively), while endometrial polyps were detected in 25.59% of women in the group II. Endometrial hyperplasia was diagnosed in the vast majority (69.76%) in group II, hyperplasia without atypia was detected in 51.16% and endometrial hyperplasia with atypia in 18.60%.Conclusions. Endometrial hyperplasia value was higher in postmenopausal women with metabolic syndrome compared to patients with normal weight, overweight and obesity. There was an increase of Ki-67, Bcl-2 and COX-2 expression in the endometrial glands in women with metabolic syndrome in comparison to patients with normal weight and obesity, for which only increased Bcl-2 expression in the stroma was observed. This confirms the existing data on the predominance of the apoptosis inhibition over proliferation in the formation of endometrial diseases in the postmenopausal period and confirms the combination of hyperproliferative processes and apoptosis inhibition if there is metabolic syndrome.read more
Citations
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Therapeutic options of endometrial hyperplasia management. Current recommendations and prospective directions of treatment: Огляд літератури
TL;DR: Cridanimod as discussed by the authors is a new small molecule that has been shown in studies to increase the progesterone receptors expression in the endometrium, thus improving the effectiveness of treatment.
References
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WHO Classification of Tumours of Female Reproductive Organs
autoři Kurman,Carcangiu +1 more
TL;DR: This authoritative, concise reference book provides an international standard for oncologists and pathologists and will serve as an indispensable guide for use in the design of studies monitoring response to therapy and clinical outcome.
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American Cancer Society Guidelines for the Early Detection of Cancer: Update of Early Detection Guidelines for Prostate, Colorectal, and Endometrial Cancers: ALSO: Update 2001—Testing for Early Lung Cancer Detection
Robert A. Smith,Andrew C. von Eschenbach,Richard C. Wender,Bernard Levin,Tim Byers,David A. Rothenberger,Durado Brooks,William T. Creasman,Carmel J. Cohen,Carolyn D. Runowicz,Debbie Saslow,Vilma Cokkinides,Harmon J. Eyre +12 more
TL;DR: The authors review the “cancer‐related check‐up,” clinical encounters that provide case‐finding and health counseling opportunities, and the ACS is issuing an updated narrative related to testing for early lung cancer detection for clinicians and individuals at high risk of lung cancer in light of emerging data on new imaging technologies.
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Type I and II Endometrial Cancers: Have They Different Risk Factors?
Veronica Wendy Setiawan,Hannah P. Yang,Malcolm C. Pike,Malcolm C. Pike,Susan E. McCann,Susan E. McCann,Herbert Yu,Yong-Bing Xiang,Alicja Wolk,Nicolas Wentzensen,Noel S. Weiss,Penelope M. Webb,Piet A. van den Brandt,Koen Van de Vijver,Pamela J. Thompson,Brian L. Strom,Brian L. Strom,Amanda B. Spurdle,Robert A. Soslow,Xiao-Ou Shu,Catherine Schairer,Carlotta Sacerdote,Thomas E. Rohan,Kim Robien,Harvey A. Risch,Fulvio Ricceri,Timothy R. Rebbeck,Radhai Rastogi,Jennifer Prescott,Silvia Polidoro,Yikyung Park,Sara H. Olson,Kirsten B. Moysich,Anthony B. Miller,Anthony B. Miller,Marjorie L. McCullough,Rayna K. Matsuno,Anthony M. Magliocco,Galina Lurie,Lingeng Lu,Jolanta Lissowska,Xiaolin Liang,James V. Lacey,Laurence N. Kolonel,Brian E. Henderson,Susan E. Hankinson,Niclas Håkansson,Marc T. Goodman,Mia M. Gaudet,Montserrat Garcia-Closas,Christine M. Friedenreich,Jo L. Freudenheim,Jennifer A. Doherty,Jennifer A. Doherty,Immaculata De Vivo,Immaculata De Vivo,Kerry S. Courneya,Linda S. Cook,Chu Chen,James R. Cerhan,Hui Cai,Louise A. Brinton,Leslie Bernstein,Kristin E. Anderson,Hoda Anton-Culver,Leo J. Schouten,Pamela L. Horn-Ross +66 more
TL;DR: The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors, and the etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.
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Oncologic and Reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 Adenocarcinoma: A systematic review
TL;DR: Endometrial hyperplasia has a significantly higher likelihood of response (66%) to hormonal therapy than grade 1 endometrial carcinoma (48%).