Display options
Cite
Goncharenko VM, Beniuk VA, Kalenska OV, et al. Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age. EPMA J. 2013;4(1):24doi: 10.1186/1878-5085-4-24.
Goncharenko, V. M., Beniuk, V. A., Kalenska, O. V., Demchenko, O. M., Spivak, M. Y., & Bubnov, R. V. (2013). Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age. The EPMA journal, 4(1), 24. https://doi.org/10.1186/1878-5085-4-24
Goncharenko, Vadym M, et al. "Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age." The EPMA journal vol. 4,1 (2013): 24. doi: https://doi.org/10.1186/1878-5085-4-24
Goncharenko VM, Beniuk VA, Kalenska OV, Demchenko OM, Spivak MY, Bubnov RV. Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age. EPMA J. 2013 Dec 06;4(1):24. doi: 10.1186/1878-5085-4-24. PMID: 24314145; PMCID: PMC3866390.
Copy Download .nbib Format: NLM
Share it on

EPMA J. 2013 Dec 06;4(1):24. doi: 10.1186/1878-5085-4-24.

Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age.

The EPMA journal

Vadym M Goncharenko, Vasyl A Beniuk, Olga V Kalenska, Olga M Demchenko, Mykola Ya Spivak, Rostyslav V Bubnov

Affiliations

  1. Clinical Hospital 'Pheophania' of State Affairs Department, Zabolotny str,, 21, Kyiv 03680, Ukraine. [email protected].

PMID: 24314145 PMCID: PMC3866390 DOI: 10.1186/1878-5085-4-24

Abstract

INTRODUCTION: Endometrial hyperplasia has a high risk for malignant transformation and relapses; existing mini-invasive treatments may lead to irrevocable endometrium destruction. The aims were to analyze receptor systems in endometrial hyperplasia, to evaluate the capabilities of ultrasonography, sonoelastography for diagnosis and treatment control, and to develop treatment algorithm.

MATERIALS AND METHODS: We included 313 women (20-45 years), assessed into the following: group 1 (n = 112) with glandular cystic hyperplasia, group 2 (n = 98) endometrial polyps, and group 3 (n = 103) atypical hyperplasia; and 82 controls who have undergone hysteroscopy before in vitro fertilization in tubal origin infertility were also included. Patients underwent clinical examination, transvaginal ultrasound, immunohistochemical study, and hormonal therapy/hysteroresectoscopy.

RESULTS: In patients with glandular hyperplasia, we registered increase of endometrium estrogen receptors (75.6% in the epithelium and 30.9% in the stroma; in controls, 43.3% and 29.6%, respectively); in polyps, there was a significant estrogen receptor increase in the stroma (48.2% vs 29.6% in controls), and in atypical hyperplasia, progesterone receptors significantly increased in the stroma. Ki-67 increased (40% to 50%) in the epithelium without changes in the stroma. Ultrasound has a sensitivity of 96% and a specificity of 85% for early detection of endometrial pathology and prediction outcome of intervention, and sonoelastography has a sensitivity of 91% and a specificity of 83% for polyp diagnosis. Personalized treatment was effective in 88.8%, relapse was diagnosed in 11.2% after 6 months, and conservative treatment of atypical hyperplasia was effective in 45%: in 25.8%, ablative hysteroresectoscopy was performed, while in 22.6% with comorbidities, hystero/oophorectomies were performed.

CONCLUSIONS: The evaluation of receptor status with ultrasound data in patients with endometrial hyperplasia allows for a clear definition of the treatment policy, avoidance of relapse, treatment optimization, and observation of such patients.

References

  1. Int J Gynecol Pathol. 2002 Oct;21(4):375-82 - PubMed
  2. Radiol Clin North Am. 2003 Jul;41(4):769-80 - PubMed
  3. Am J Obstet Gynecol. 2001 Jan;184(2):70-5 - PubMed
  4. Gynecol Oncol. 2000 Apr;77(1):11-7 - PubMed
  5. Gynecol Obstet Invest. 2006;61(1):24-8 - PubMed
  6. EPMA J. 2013 Feb 19;4(1):6 - PubMed
  7. Radiology. 1991 Aug;180(2):427-32 - PubMed
  8. J Clin Ultrasound. 1990 Mar-Apr;18(3):173-7 - PubMed
  9. Science. 1995 Mar 10;267(5203):1456-62 - PubMed
  10. Ginekol Pol. 2011 Jul;82(7):494-7 - PubMed
  11. J Clin Ultrasound. 2004 Sep;32(7):348-53 - PubMed
  12. Oncology. 1998 Dec;55 Suppl 1:35-44 - PubMed
  13. EPMA J. 2010 Mar;1(1):130-7 - PubMed
  14. J Midwifery Womens Health. 2006 Nov-Dec;51(6):440-9 - PubMed
  15. EPMA J. 2013 Jul 29;4(1):20 - PubMed
  16. Gynecol Oncol. 2013 May;129(2):324-31 - PubMed
  17. J Ultrasound Med. 2001 Oct;20(10):1025-36 - PubMed
  18. Maturitas. 2001 Apr 20;38(2):179-88 - PubMed
  19. J Am Assoc Gynecol Laparosc. 1996 Nov;4(1):13-8 - PubMed
  20. Mod Pathol. 2000 Apr;13(4):379-88 - PubMed
  21. Int J Gynecol Pathol. 1996 Oct;15(4):345-8 - PubMed
  22. J Clin Oncol. 2006 Oct 10;24(29):4783-91 - PubMed
  23. Am J Obstet Gynecol. 1991 Jan;164(1 Pt 1):47-52 - PubMed
  24. Gynecol Oncol. 2003 Nov;91(2):309-17 - PubMed
  25. J Obstet Gynaecol. 2009 May;29(4):340-6 - PubMed
  26. J Minim Invasive Gynecol. 2007 May-Jun;14(3):300-3 - PubMed
  27. BJOG. 2004 Nov;111(11):1242-7 - PubMed
  28. Gynecol Oncol. 1996 May;61(2):167-74 - PubMed
  29. EPMA J. 2012 Nov 01;3(1):14 - PubMed
  30. Eur J Cancer. 2000 Sep;36 Suppl 4:108-9 - PubMed
  31. Gynecol Oncol. 2005 Jun;97(3):740-50 - PubMed
  32. Obstet Gynecol. 1991 Aug;78(2):195-9 - PubMed
  33. Cancer Res. 2001 Jun 1;61(11):4311-4 - PubMed
  34. Gynecol Oncol. 2003 Feb;88(2):108-17 - PubMed
  35. Maturitas. 2001 Dec 14;40(3):273-81 - PubMed
  36. Br J Obstet Gynaecol. 1999 Dec;106(12):1259-64 - PubMed
  37. J Clin Endocrinol Metab. 1997 Aug;82(8):2738-46 - PubMed
  38. Fertil Steril. 1997 May;67(5):856-64 - PubMed
  39. Cancer. 2006 Feb 15;106(4):812-9 - PubMed
  40. Gynecol Endocrinol. 2004 Jun;18(6):299-304 - PubMed
  41. EPMA J. 2013 Sep 16;4(1):22 - PubMed
  42. Arch Histol Cytol. 2004 Dec;67(5):393-409 - PubMed
  43. Acta Obstet Gynecol Scand. 1991;70(7-8):591-4 - PubMed
  44. Lik Sprava. 2011 Apr-Jun;(3-4):108-13 - PubMed
  45. Przegl Lek. 2005;62(4):227-9 - PubMed
  46. EPMA J. 2013 Jan 12;4(1):1 - PubMed
  47. J Clin Endocrinol Metab. 1996 Nov;81(11):4144-7 - PubMed
  48. Ultrason Imaging. 1991 Apr;13(2):111-34 - PubMed
  49. Maturitas. 2007 Feb 20;56(2):190-7 - PubMed
  50. Lancet. 2011 Aug 27;378(9793):815-25 - PubMed
  51. J Obstet Gynaecol Can. 2002 Feb;24(2):131-6 - PubMed
  52. N Engl J Med. 1997 Dec 18;337(25):1792-8 - PubMed
  53. J Cell Mol Med. 2002 Apr-Jun;6(2):151-9 - PubMed
  54. EPMA J. 2012 Oct 22;3(1):13 - PubMed
  55. J Clin Endocrinol Metab. 2002 Jun;87(6):2960-6 - PubMed
  56. BJOG. 2003 Sep;110(9):794-8 - PubMed
  57. CA Cancer J Clin. 2005 Mar-Apr;55(2):74-108 - PubMed
  58. Gynecol Oncol. 2000 Nov;79(2):169-76 - PubMed
  59. Am J Surg Pathol. 2012 Nov;36(11):1683-90 - PubMed
  60. Hum Reprod Update. 2007 Jan-Feb;13(1):87-101 - PubMed
  61. Blood. 1992 Aug 15;80(4):879-86 - PubMed
  62. Gynecol Oncol. 2013 Apr;129(1):216-21 - PubMed
  63. Gynecol Oncol. 1998 Aug;70(2):188-91 - PubMed
  64. Adv Anat Pathol. 2011 Nov;18(6):415-37 - PubMed
  65. Am J Obstet Gynecol. 1995 May;172(5):1488-94 - PubMed

Publication Types