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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2013, Number 09

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Ginecol Obstet Mex 2013; 81 (09)

Incidence of Endometrial Cancer in Patients with Biopsy Specimens of Endometrial Hyperplasia

Zeferino-Toquero M, Bañuelos-Flores J, Maytorena-Córdova G, Reyna-Amaya H, Acevedo-Vega MF
Full text How to cite this article

Language: Spanish
References: 19
Page: 519-524
PDF size: 170.54 Kb.


Key words:

Endometrial cáncer, endometrial neoplasms, endometrial hyperplasia, atypical endometrial hyperplasia, complex endometrial hyperplasia.

ABSTRACT

Background: According to the Histopathological Registry of Malignant Neoplasms in Mexico, endometrial cancer ranks third gynecological cancers after cervical cancer and ovarian cancer. In 2003 represented 2.16% of all female cancers and in 2007 was the cause of 2.8% of hospital discharges nationwide cancer.
Objective: To determine the possibility of coincidence of endometrial cancer in biopsy specimens of patients with endometrial hyperplasia.
Material and methods: We analyzed patients who underwent hysterectomy for hyperplasia preoperative biopsy between January 2007 and October 2008.
Results: We found 86 patients with biopsy specimens of hyperplasia who underwent hysterectomy, hyperplasia was confirmed in 70 (group A) and endometrioid endometrial cáncer reported in 16 (group B). We found cáncer in 2 of 61 patients with simple hyperplasia without atypia (3.2%), none of the 6 patients with atypical hyperplasia was found simple cáncer (0%) and 19 patients with complex hyperplasia with atypia was documented EC 14 (73.68%). Patients in group B are older vs 51.3 44.4 years, have a lower number of pregnancies 2.6 vs 3.1 and have a higher body mass index 34.71 vs 29.05 than group A.
Conclusion: The percentage of agreement between complex endometrial hyperplasiaand endometrial cancer is the highest reported in the literature. Endometrial biopsy in our hospital has low sensitivity for predicting coexistence between complex endometrial hyperplasia and CE. Patients with endometrial biopsy complex endometrial hyperplasia associated with BMI greater than 30 and age over 50 years are at high risk for having coexistence with endometrial cancer. For the high frequency of coexistence with cancer, patients with preoperative biopsy complex endometrial hyperplasia should undergo hysterectomy with frozen section of the uterus to avoid reoperation in case of malignancy.


REFERENCES

  1. American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society, 2009.

  2. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer Statistics 2009. CA Cancer J Clin 2009;59:225-249.

  3. Dirección General de Estadística, Secretaría de Salud. Compendio del Registro Histopatológico de Neoplasias Malignas. México, DGE-SSA, 2003.

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

  5. Tabata T, Yamawaki T, Yabana T, Ida M, Nishimura K, Nose Y. Natural history of endometrial hyperplasia. Arch Gynecol Obstet 2001;265:85-88.

  6. Ronnet BM, Kurman, RJ. Precursor lesions of endometrial carcinoma. In: Kurman RJ editor. Blaustein’s Pathology of the Female Genital Tract. New York: Springer-Verlag, 1994;467-483.

  7. Xing X, Wei-Gou L, Da-Feng Y, Huai-Zeng Ch and Yun- Feng F. The Value of Curettage in Diagnosis of Endometrial Hyperplasia. Gynecol Oncol 2002;84:135-139.

  8. Widra EA, Dunton CJ, McHugh M, Palazzo JP. Endometrial hyperplasia and the risk of carcinoma. Int J Gynecol Cancer 1995;5:233-235.

  9. Bilgin T, Ozuysai S, Ozan H, Atakan T. Coexisting endometrial cancer in patients with a preoperative diagnosis of atypical endometrial hyperplasia. J Obstet Gynaecol Res 2004;30:205-209.

  10. Merisio C, Berretta R, De Ioris A, Pultrone DC, Roalla M, Giordano G, et al. Endometrial cancer in patients with preoperative diagnosis of atypical endometrial hyperplasia. Eur J Obstet Gynecol Reprod Bio 2005;122:107-111.

  11. Novac L, Grigore T, Cernea N, Niculescu M, Cotarcea S. Incidence of endometrial carcinoma in patients with endometrial hyperplasia. Eur J Gynaecol Oncol 2005;5:561-563.

  12. 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;14:348-353.

  13. Trimble CL, Kauderer J, Zaino R, Silverberg S, Lim PC, Burke II JJ, et al. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecological Oncology Group Study. Cancer 2006;106:812-9.

  14. Yu-Li Ch, Wen-Fang Ch, Ming-Chieh L, Chia-Yen H, Chang-Yao H, Chi-An Ch. Concurrent endometrial carcinoma in patients with a curettage diagnosis of endometrial hyperplasia. J Formos Med Assoc 2009;108:502-507.

  15. Janicek MF, Rosenshein NB. Invasive endometrial cancer in uteri resected for atypical endometrial Hyperplasia. Gynecol Oncol 1994;52:373-378.

  16. Gundem G, Sendag F, Kazandi M, Akercan F, Mgoyi L, Terek MC et al. Preopertive and postoperative correlation of histopathological findings in cases of endometrial hyperplasia. Eur J Gynaecol Oncol 2003; 24:330-333.

  17. Dijkhuizen FP, Mol BW, Brolmann HA and Heintz APM. The accurancy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia. A meta-analysis. Cancer 2000;89:1765-1772.

  18. Zaino RJ, Kauderer J, Trimble CL, Silverberg SG, Curtin JP, Lim PC, et al. Reproducibility of the Diagnosis of Atypical Endometrial Hyperplasia. A Gynecologic Oncology Group Study. Cancer 2006;106:804-11.

  19. Soslow RA. Problems with the current diagnostic approach to complex atypical endometrial hyperplasia. Cancer 2006;106:729-31.




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Ginecol Obstet Mex. 2013;81