Clinicopathologic Aspects of Endometrial Proliferous Processes in Women of Reproductive Age

In: Galician Medical Journal · 2017 · vol. 24(4) · doi:10.21802/gmj.2017.4.8 · W2793487769
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Benign endometrial proliferative pathology, common in reproductive-aged women, often coexists with chronic inflammation, infertility, and other gynecological conditions like uterine leiomyoma and adenomyosis.

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The paper reviews clinicopathologic features of benign proliferative endometrial processes without atypia in reproductive-age women, analyzing pathohistologic findings and applying statistical processing. It reports that benign proliferative pathology is frequent in this population (52.2% of cases) and that endometrial polyps showed morphological signs of chronic inflammation in 56.5% of cases versus 38.2% for endometrial hyperplasia, which the authors interpret as evidence of long-term inflammation contributing to proliferative development. Infertility was present in roughly 44–48% of women with chronic salpingo-oophoritis across groups defined by polyps, hyperplasia, or combined proliferative pathology, and menstrual disorders occurred in about 30% of women with hyperplasia or co-existent polyposis. The paper notes morphological–clinical interpretation limitations inherent to a review/analysis design and does not detail causality; relevance to endometriosis and/or adenomyosis appears through reported co-occurrence with adenomyosis (and uterine leiomyoma), where endometrial hyperplasia and polyps were found in subsets of patients with adenomyosis. This paper does not explicitly discuss endometriosis or adenomyosis as a primary outcome beyond citing and quantifying their coexistence with endometrial proliferous processes.

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Abstract

The peculiarities of benign proliferative pathology of endometrium including their combination in women of reproductive age are reviewed in the article.Materials and methods. The results of pathohistological research of benign proliferative pathology of endometrium (without atypia) were analyzed. Statistical data processing was performed by means of MedStat software package.Results. The obtained results revealed that benign proliferative pathology of endometrium is one of the most frequent gynaecological malignancies among female patients of reproductive age accounting for 52.2 % cases. Endometrial polyps were found to be accompanied by morphological peculiarities indicating chronic inflammatory process in endometrium in 56.5% cases (р<0.05) in comparison with endometrial hyperplasia in 38.2% cases, proving the presence of long-term inflammation in endometrial tissue and its trigger role in the development of the proliferative processes. Among patients with chronic salpingo-oophoritis, infertility was revealed in almost half of cases (44.5% of patients with endometrial polyps, 40.5% of patients with endometrial hyperplasia and 48.3% of women with combined proliferative pathology of endometrium) clinically confirming the data of morphological research. Peculiar signs of proliferative processes in genitals were determined, namely coexistence of uterine and endometrial pathology: endometrial hyperplasia was found in 40.4% of patients with uterine leiomyoma and 30.3% of patients with adenomyosis. The same combinations were peculiar for patients with endometrial polyps: endometrial hyperplasia was found in 30.1% of patients with uterine leiomyoma and 36.3% of patients with adenomyosis. Menstrual disorders were revealed in every third woman with endometrial hyperplasia (30.3%) and co-existent polyposis (30.2%).
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Abstract

The peculiarities of benign proliferative pathology of endometrium including their combination in women of reproductive age are reviewed in the article.

Materials

and methods. The results of pathohistological research of benign proliferative pathology of endometrium (without atypia) were analyzed. Statistical data processing was performed by means of MedStat software package. Results. The obtained results revealed that benign proliferative pathology of endometrium is one of the most frequent gynaecological malignancies among female patients of reproductive age accounting for 52.2 % cases. Endometrial polyps were found to be accompanied by morphological peculiarities indicating chronic inflammatory process in endometrium in 56.5% cases (р<0.05) in comparison with endometrial hyperplasia in 38.2% cases, proving the presence of long-term inflammation in endometrial tissue and its trigger role in the development of the proliferative processes. Among patients with chronic salpingo-oophoritis, infertility was revealed in almost half of cases (44.5% of patients with endometrial polyps, 40.5% of patients with endometrial hyperplasia and 48.3% of women with combined proliferative pathology of endometrium) clinically confirming the data of morphological research. Peculiar signs of proliferative processes in genitals were determined, namely coexistence of uterine and endometrial pathology: endometrial hyperplasia was found in 40.4% of patients with uterine leiomyoma and 30.3% of patients with adenomyosis. The same combinations were peculiar for patients with endometrial polyps: endometrial hyperplasia was found in 30.1% of patients with uterine leiomyoma and 36.3% of patients with adenomyosis. Menstrual disorders were revealed in every third woman with endometrial hyperplasia (30.3%) and co-existent polyposis (30.2%).

References

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