COMPARATIVE ANALYSIS OF DIAGNOSTIC CRITERIA FOR ENDOMETRIAL HYPERPLASTIC PROCESSES

2021 ◽  
pp. 28-32
Author(s):  
N.S. Akulich ◽  
◽  
V.М. Savickaya ◽  
V.V. Dziadzichkina ◽  
◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Endometrial Cancer ◽  
Diagnostic Criteria ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Age Groups ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Morphological Examination ◽  
Gynecological Diseases

Endometrial hyperplastic processes are currently among the most common gynecological diseases, tend to a long, recurrent course, are characterized by the absence of specific, pathognomonic symptoms and the complexity of differential diagnosis. With a prolonged course without treatment, endometrial cancer develops in 25 % of cases against the background of benign endometrial changes. The diagnostic criteria allowing to refer the patient for separate diagnostic curettage are contradictory and not always reliable. The aim of this work was to study the informativeness of clinical data, indicators of ultrasound examination in the diagnosis of endometrial hyperplastic processes in different age periods, which is very important for identifying the most accurate methods for diagnosing this pathology. The current work analyzes the diagnostic criteria of endometrial hyperplasia and the results of histological examination of the endometrium in women of different age groups. A high percentage of discrepancy between clinical (47.8 % of cases) and ultrasound (60.4 % of cases) data with the results of patho- morphological examination in the perimenopausal period in the diagnosis of endometrial hyperplastic processes was established. The results obtained confirm the need for a differentiated approach to referral of patients, especially of perimenopausal age, to separate diagnostic curettage of the mucous membrane of the uterine cavity and cervical canal in case of suspected endometrial hyperplasia, taking into account complaints, the woman's age and ultrasound data.

Hysteroscopic and morphological assessment of intrauterine pathology in different age periods

2020 ◽  
Vol 69 (2) ◽  
pp. 51-58
Author(s):  
Anna N. Sulima ◽  
Inna O. Kolesnikova ◽  
Aleksandra A. Davydova ◽  
Maxim A. Kriventsov
Keyword(s):  
Retrospective Analysis ◽  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Age Groups ◽  
Uterine Cavity ◽  
Reproductive Period ◽  
Morphological Data ◽  
Gynecological Diseases ◽  
Diagnostic Capabilities ◽  
Morphological Assessment

The pathology of the endo- and myometrium takes the main place in the structure of gynecological diseases. The introduction of endoscopic technologies has expanded the diagnostic capabilities of the study of intrauterine pathology. The morphological method is the gold standard in diagnosing the uterine cavity pathology. A retrospective analysis of 100 video protocols of hysteroscopy and morphological data obtained in Vash Doctor Clinic Ltd., Simferopol over the year 2018 was performed. During a retrospective analysis of hysteroscopic pictures and pathomorphological findings, all patients were divided into three age groups: (I) 2535 years old (35 women); (II) 3645 years old (35 women); and (III) 4655 years old (30 women). In the early reproductive period, endometrial hyperplasia without atypia prevailed, chronic endometritis prevailing in the late reproductive period, and polyps of the uterus in the period of the menopausal transition and postmenopause.

scholarly journals Risk Assessment of Endometrial Hyperplasia or Endometrial Cancer with Simplified Ultrasound-Based Scoring Systems

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 442
Author(s):  
Norbert Stachowicz ◽  
Agata Smoleń ◽  
Michał Ciebiera ◽  
Tomasz Łoziński ◽  
Paweł Poziemski ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Menopausal Status ◽  
Power Doppler ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Scoring Systems ◽  
Diagnostic Challenge

Background: Abnormal uterine bleeding (AUB) represents a common diagnostic challenge, as it might be related to both benign and malignant conditions. Endometrial cancer may not be detected with blind uterine cavity sampling by dilatation and curettage or suction devices. Several scoring systems using different ultrasound image characteristics were recently proposed to estimate the risk of endometrial cancer (EC) in women with AUB. Aim: The aim of the present study was to externally validate the predictive value of the recently proposed scoring systems including the Risk of Endometrial Cancer scoring model (REC) for EC risk stratification. Material and methods: It was a retrospective cohort study of women with postmenopausal bleeding. From June 2012 to June 2020 we studied a group of 394 women who underwent standard transvaginal ultrasound examination followed by power Doppler intrauterine vascularity assessment. Selected ultrasound features of endometrial lesions were assessed in each patient. Results: The median age was 60.3 years (range ±10.7). The median body mass index (BMI) was 30.4 (range ± 6.0). Histological examination revealed 158 cases of endometrial hyperplasia (EH) and 236 cases of EC. Of the studied ultrasound endometrial features, the highest areas under the curve (AUCs) were found for endometrial thickness (ET) (AUC = 0.76; 95% CI: 0.71–0.81) and for interrupted endomyometrial junction (AUC = 0.70, 95% CI: 0.65–0.75). Selected scoring systems presented moderate to good predictive performance in differentiating EC and EH. The highest AUC was found for REC model (AUC = 0.75, 95% CI: 0.70–0.79) and for the basic model that included ET, Doppler score and interrupted endometrial junction (AUC = 0.77, 95% CI: 0.73–0.82). REC model was more accurate than other scoring systems and selected single features for differentiating benign hyperplasia from EC at early stages, regardless of menopausal status. Conclusions: New scoring systems, including the REC model may be used in women with AUB for more efficient differentiation between benign and malignant conditions.

scholarly journals Echographic study of the variation in endometry thickness in women 15 to 40 years old in Lokossa district in Benin

2021 ◽  
Vol 12 (2) ◽  
pp. 500-509
Author(s):  
Gbaguidi Ahotondji Bertin ◽  
Avocefohoun Sako Alphonse ◽  
Komabou Fulbert ◽  
Youssao Abdou Karim Alassane ◽  
Gbaguidi Nonvignon Magloire ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Ultrasound Examination ◽  
Age Groups ◽  
Uterine Cavity ◽  
Longitudinal Section ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
Ovulatory Period

The endometrium is a deep, basal, very thin layer lining the uterine cavity that changes during the menstrual cycle. The present work is a contribution to assess the thickness of the endometrium according to the period of the menstrual cycle in women aged 15 to 40 years. This is a descriptive and prospective cross-sectional study involving 166 women aged 15 to 40 years in Lokossa. Ultrasound examination measured the thickness of the endometrium on the longitudinal section through the suprapubic route. Anthropometric parameters were taken by other equipment in each woman. At the end of the study, the minimum, average and maximum values ​​of the thickness of the endometrium obtained are respectively Vm = 3.50 mm, VMoy = 6.73 ± 1.38 mm, MV = 10.00 mm during the pre-ovulatory phase, Vm = 7.30 mm, VMoy = 10.75 ± 2.11 mm, MV = 16.00 mm during the post-ovulatory period. There is a link of association between the thickness of the endometrium and the phases of the cycle (P = 0.0000), but the test is statistically significant between the thickness and the age groups and the Mass Index Body (BMI). This allows us to say that the thickness of the endometrium normally varies with the phases of the menstrual cycle and with age.

scholarly journals The role of hysteroresectoscopy in the diagnosis and treatment of reproductive age women with uterine leiomyoma

2021 ◽  
Vol 5 ◽  
pp. 61-64
Author(s):  
M.A. Flaksemberg
Keyword(s):  
Menstrual Cycle ◽  
Histological Examination ◽  
Uterine Leiomyoma ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
Chronic Endometritis ◽  
Reproductive Age Women ◽  
Ultrasound Findings

The objective: to investigate the features of hysteroscopic picture of the uterine cavity and endometrium condition in women with uterine leiomyoma (UL) and the possibility of using the results to choose a treatment method.Materials and methods. A total amount of reproductive age women with uterine leiomyoma that was examined is 216. Among them 118 women underwent surgical treatment for UL and 98 patients treated with conservative therapy. In addition to general clinical methods, ultrasound examination, hysterorectoscopy, and histological examination of the obtained material was performed, followed by a comparative analysis of the findings.Results. According to hysteroresectoscopy, the uterine cavity in women with UL was more frequently characterized by irregular wall relief (47.7%) and irregular shape (43.1%) due to submucosal (14.4%) and intramural nodes with centripetal growth (30.6% ), which was significantly more frequent compared to ultrasound findings (13.9%, p<0.05). Endometrial polyps predominated among endometrial pathology (55.6%), which was consistent with the histological finding (59.7%) and was twice as frequent as ultrasound findings (23.1%, p<0.05). And endometrial hyperplasia (14.8%), which was consistent with ultrasound findings (18.1%) but was twice as rare compared to histological examination (36.6%, p<0.05). Chronic endometritis was detected at hysteroscopy in less than 1% of subjects, whereas at histological examination, it was 26.4%, p<0.05. Ultrasound examination revealed no endometrial transformation during the cycle in 30.1% of women, which was consistent with a mismatch in endometrial development to the chronological day of the menstrual cycle according to histological examination (23.1%).Conclusion. Hysteroresectoscopy is an important stage in the examination of women with UL, which helps to assess the condition of the uterine cavity, in particular, the degree of deformation of leiomatous nodules, which determines the clinical course of the disease and is a contributing factor to infertility, and affects the choice of treatment tactics in this cohort of patients. Hysteroresectoscopy when combined with ultrasound and histological examination of the endometrium, a more comprehensive characterisation of the endometrial condition (chronic endometritis, mismatch of the day of the menstrual cycle) and the presence of associated pathological processes (polyps and endometrial hyperplasia) that require correction can be obtained.

scholarly journals Differential diagnosis between normal endometrium and endometrial hyperplasia with immunostaining cytology using anti-LeY monoclonal antibody

2003 ◽  
Vol 13 (1) ◽  
pp. 42-46
Author(s):  
Y. Arai ◽  
M. Nishida
Keyword(s):  
Monoclonal Antibody ◽  
Differential Diagnosis ◽  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Negative Staining ◽  
Positive Staining ◽  
Normal Endometrium ◽  
Number Of Cells

We have previously reported that both endometrial cancer and endometrial hyperplasia stain positively for the anti-LeY monoclonal antibody, whereas normal endometrium does not. Endometrial hyperplasia is a premalignant change associated with the eventual development of endometrial carcinoma. However, it can be difficult to differentiate hyperplasia from normal endometrium in cytology. This study illustrates the use of immunocytochemical cytology using anti-LeY monoclonal antibody to differentiate between endometrial hyperplasia and normal endometrium. Immunostaining using anti-LeY monoclonal antibody was performed on cytologic specimens obtained from 17 normal endometria, 25 endometria with endometrial hyperplasia, and 13 endometria with endometrial carcinoma. All normal endometria displayed negative staining for anti-LeY monoclonal antibody, whereas all endometria with endometrial carcinoma displayed positive staining. Of the endometrial hyperplasia cases, 21 displayed positive staining. However, four displayed negative staining due to the small number of cells available for diagnosis. We believe that immunostaining cytology using anti-LeY monoclonal antibody is a useful method for differentiating between normal endometrium and endometrial hyperplasia.

Endometrial hyperplasia: without atypia and with atypia

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 18-24
Author(s):  
Maksim A. Sabantsev ◽  
Svetlana V. Shramko ◽  
Vladimir G. Levchenko ◽  
Oleg A. Volkov ◽  
Tatyana V. Tretyakova
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Research Methods ◽  
Endometrial Hyperplasia ◽  
Menopausal Hormone Therapy ◽  
Pubmed Database ◽  
Gynecological Diseases ◽  
Current Classification

The article analyzes and presents data for the last 70 years from the PubMed database on endometrial hyperplasia (EH), which is one of the leaders in the structure of gynecological diseases and the main predictor of endometrial cancer (EC). The chronicle of the EH classification is highlighted with a focus on changing the designation and relevance of adenomatous EH. It is shown how the current classification of EH, due to the fact that a large number of synonyms is limited by two options, allows to maximize the reproducibility of the diagnosis, improve the interaction of the obstetrician-gynecologist with the pathologist and reduce the treatment inefficiency. The results of modern studies on the prevalence and risk factors of EH and EC differ from previously accepted ones and destroy the Bohman triad. The risks of EH development with tamoxifen and menopausal hormone therapy are determined. The data of current research methods aimed at the diagnosis of EH and EC are indicated. The differences in etiopathogenesis, prevalence, diagnosis, risk factors for development and progression to the malignant process presented in the review represent two types of EH (without atypia and with atypia) as completely different endometrial diseases included in the same classification.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

LIPID PEROXIDATION AND ANTIOXIDANT PROTECTION SYSTEM IN WOMEN WITH ENDOMETRIAL HYPERPLASTIC PROCESSES

2019 ◽  
pp. 44-49
Author(s):  
A.O. Atykanov ◽  
G.U. Asymbekova ◽  
A.A. Masybaeva
Keyword(s):  
Lipid Peroxidation ◽  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
Support Network ◽  
Antioxidant Protection ◽  
Women Of Reproductive Age ◽  
Atypical Form ◽  
Antioxidant Protection System ◽  
Quantitative Indicators

The paper presents quantitative indicators of lipid peroxidation (LP) products and antioxidant support network (ASN) in blood plasma in women with various histological forms of endometrial hyperplastic processes (EHPs). The goal of the paper is to assess the state of LP processes and ASN in women of reproductive age with various forms of EHPs. Materials and Methods. The trial enrolled 137 women of reproductive age: 112 women with endometrial hyperplasia (EH) and 25 women with uterine cavity synechia without EH. Conclusion. In case if EH progresses from a simple atypical form to adenocarcinoma, an increase in lipid peroxidation intensity and ASN inhibition is observed. Keywords: women, endometrial hyperplastic processes, endometrial hyperplasia, lipid peroxidation, antioxidant support network. В работе представлены количественные показатели содержания продуктов перекисного окисления липидов (ПОЛ) и системы антиоксидантной защиты (АОЗ) в плазме крови у женщин с различными гистологическими формами гиперпластического процесса эндометрия (ГПЭ). Цель исследования. Оценить состояние процессов ПОЛ и системы АОЗ при развитии различных форм ГПЭ у женщин репродуктивного возраста. Материалы и методы. Объектом исследования явились 137 женщин репродуктивного возраста: 112 женщин с гиперплазией эндометрия (ГЭ) и 25 женщин с синехиями полости матки без ГЭ. Выводы. При прогрессировании ГЭ от простой неатипичной до аденокарциномы происходит нарастание интенсивности липопереокисления и угнетения системы АОЗ. Ключевые слова: женщины, гиперпластические процессы эндометрия, гиперплазия эндометрия, перекисное окисление липидов, система антиоксидантной защиты.

scholarly journals Upregulation of Serum lncRNA DLEU1 Predicts Progression of Premalignant Endometrial Lesion and Unfavorable Clinical Outcome of Endometrial Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303382096558
Author(s):  
Lixia Shan ◽  
Tao Zhao ◽  
Yu Wang
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Cox Regression ◽  
Quantitative Polymerase Chain Reaction ◽  
Critical Role ◽  
Disease Free Survival ◽  
Lymphocytic Leukemia ◽  
Healthy Controls ◽  
Clinical Value ◽  
Cox Regression Analysis

Objective: Long non-coding RNAs (lncRNAs) play a critical role in tumorigenesis. Upregulation of lncRNA deleted in lymphocytic leukemia 1 (DLEU1) has been reported in endometrial cancer (EC) tissues. This prospective study aimed to determine the potential clinical significance of serum lncRNA DLEU1 in EC. Methods: The serum lncRNA DLEU1 level was detected in EC patients, patients with endometrial hyperplasia and healthy controls by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Then its clinical value in EC was further evaluated. Results: Our results demonstrated that serum lncRNA DLEU1 levels were significantly increased in patients with EC, and serum lncRNA DLEU1 showed good performance for discriminating EC patients from patients with endometrial hyperplasia and healthy controls. In addition, EC patients with advanced clinicopathological features had higher circulating lncRNA DLEU1 level than those with favorable clinical characteristics. Moreover, EC patients in the high serum lncRNA DLEU1 group suffered worse overall survival and disease-free survival than those in the low serum lncRNA DLEU1 group. Furthermore, multivariate cox regression analysis displayed that the serum lncRNA DLEU1 served as an independent prognostic factor for EC. Conclusions: Collectively, our study suggests that serum lncRNA DLEU1 is a novel and promising biomarker for prognostic estimation of EC.

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