Risk factors for recurrence of endometrial hyperplasia in women of late reproductive and premenopausal age

In: REPRODUCTIVE ENDOCRINOLOGY · 2017 · pp. 28–31 · doi:10.18370/2309-4117.2017.34.28-31 · W2615833432
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This study identified hyperpolimenorrhea, endometrioid disease, ovarian cysts, gastrointestinal disorders, iron deficiency anemia, thyroid and breast cancer, and vegetative-vascular dystonia as risk factors for endometrial hyperplasia recurrence in women aged 35-54.

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This study investigated risk factors for recurrence of endometrial hyperplasia in 276 women aged 35–54 years, using clinical history review and long-term outcomes after diagnostic and therapeutic hysteroscopic procedures. Over 1.5 years, 88 women (31.9%) experienced relapses, and the authors compared characteristics between those with recurrence and those without using statistical testing (including Mann-Whitney, χ2, and Fisher’s exact tests). The paper reports a high overall recurrence rate and states that recurrent hyperplasia lacked nosological specificity, while recurrence was associated with higher risks in the setting of hyperpolymenorrhea, endometrioid disease—especially adenomyosis—and ovarian cysts, as well as several extragenital conditions (gastrointestinal disorders, iron deficiency anemia, thyroid and breast cancer, and vegetative-vascular dystonia). This paper is centrally about endometrial hyperplasia recurrence, and it relates to endometriosis/adenomyosis by specifically identifying adenomyosis (within endometrioid disease) as increasing the risk of recurrence.

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Abstract

According to many researchers, hyperplastic endometrial processes are not precancerous diseases. However, recurrent endometrial hyperplastic processes, as well as their combination with genital and extragenital pathologies, significantly increase the risk of malignant transformation of the endometrium. Late reproductive and premenopausal age is associated with an increase in the frequency of endometrial hyperplastic processes, extragenital pathology and operative interventions on the internal genitalia. The limited possibilities of conservative treatment in connection with concomitant diseases and the tendency of an increase in the recurring hyperplastic processes of the uterus make the problem of studying various aspects of hyperplastic endometrial processes in women of this age period extremely urgent.The purpose of research: to identify risk factors for recurrence of endometrial hyperplasia in women of late reproductive and premenopausal age.Materials and methods. We studied the clinical and medical history and long-term results of treatment of 276 women aged 35–54 years with endometrial hyperplastic processes. All patients underwent diagnostic and therapeutic hysteroscopic procedures were carried out. In 88 (31.9%) women for 1.5 years after treatment were observed relapses of the disease. These patients accounted for Рц group, the remaining 188 women included in the group K. Data processing was performed using variation statistics method, Mann-Whitney ranking test, χ2-test and Fisher’s exact test.Results and conclusions. It should be noted the high rate of recurrence of endometrial hyperplastic processes in women of late reproductive and premenopausal age and lack of nosological specificity of recurrent endometrial hyperplastic processes. At the same time, recurrence of endometrial hyperplastic processes significantly increased the risks against the backdrop of giperpolimenorei, endometrioid disease, especially, adenomyosis and ovarian cysts. The greatest chances of recurrence were associated with the presence of patients extragenital diseases: gastrointestinal disorders, iron deficiency anemia, thyroid and breast cancer, vegetative-vascular dystonia. Within the framework of all investigated factors, the chances of recurrence of endometrial hyperplastic processes are most significant increased at the vegetative-vascular dystonia, and the pathology of the lacteal and thyroid gland.
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Materials

and methods. We studied the clinical and medical history and long-term results of treatment of 276 women aged 35–54 years with endometrial hyperplastic processes. All patients underwent diagnostic and therapeutic hysteroscopic procedures were carried out. In 88 (31.9%) women for 1.5 years after treatment were observed relapses of the disease. These patients accounted for Рц group, the remaining 188 women included in the group K. Data processing was performed using variation statistics method, Mann-Whitney ranking test, χ2-test and Fisher’s exact test.

Results

and conclusions. It should be noted the high rate of recurrence of endometrial hyperplastic processes in women of late reproductive and premenopausal age and lack of nosological specificity of recurrent endometrial hyperplastic processes. At the same time, recurrence of endometrial hyperplastic processes significantly increased the risks against the backdrop of giperpolimenorei, endometrioid disease, especially, adenomyosis and ovarian cysts. The greatest chances of recurrence were associated with the presence of patients extragenital diseases: gastrointestinal disorders, iron deficiency anemia, thyroid and breast cancer, vegetative-vascular dystonia. Within the framework of all investigated factors, the chances of recurrence of endometrial hyperplastic processes are most significant increased at the vegetative-vascular dystonia, and the pathology of the lacteal and thyroid gland.

References

- Vdovychenko, Y.P., Holianovskyi, O.V., Lopushan, I.V. “Modern management of diagnosis and treatment of endometrial hyperplastic processes.” Women’s Health 9 (2012): 45–53. - Kashtalian, M.M. “Hysteroscopic surgery in patients with hyperplastic processes combined uterus.” Women’s Reproductive Health 2 (2007): 168–171. - Korniyenko, S.M. “Hysteroscopy in the diagnosis and treatment of intrauterine pathology in women of late reproductive and premenopausal age.” Pediatrics, Obstetrics and Gynecology 73.4 (2011): 219–22. - Clark, T.J., Neelakantan, D., Gupta, J.K. “The management of endometrial hyperplasia: an evaluation of current practice.” Eur J Obstet Gynecol Reprod Biol 125.2 (2006): 259–64. - Linkov, F., Edwards, R., Balk, J., et al. “Endometrial hyperplasia, endometrial cancer and prevention: gaps in existing research of modifiable risk factors.” Eur J Cancer 44.12 (2008): 1632–44. - Gallos, I.D., Ganesan, R., Gupta, J.K. “Prediction of regression and relapse of endometrial hyperplasia with conservative therapy.” Obstet Gynecol 121.6 (2013): 1165–71. - Paradisi, R., Rossi, S., Scifo, M.C., et al. “Recurrence of endometrial polyps.” Gynecol Obstet Invest 78.1 (2014): 26–32. - Gallos, I.D., Krishan, P., Shehmar, M., et al. “Relapse of endometrial hyperplasia after conservative treatment: a cohort study with long-term follow-up.” Hum Reprod 28.5 (2013): 1231–6. - Sorosky, J.I. “Endometrial cancer.” Obstet Gynecol 120.2.1 (2012): 383–97. - Ozkaya, E., Korkmaz, V., Ozkaya, Y., et al. “Ultrasonographic endometrial thickness measurement is predictive for treatment response in simple endometrial hyperplasia without atypia.” J Turk Ger Gynecol Assoc 14.1 (2013): 19–22. Downloads Published How to Cite Issue Section License Copyright (c) 2017 С. М. Корниенко This work is licensed under a Creative Commons Attribution 4.0 International License. Authors who publish with this journal agree to the following terms: - Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. - Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

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