Analysis of features of atypical hyperplasia patients with postoperative pathologic upgrade

doi:10.3969/j.issn.1006-7795.2019.06.008

Journal of Capital Medical University ›› 2019, Vol. 40 ›› Issue (6): 846-850.doi: 10.3969/j.issn.1006-7795.2019.06.008

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Analysis of features of atypical hyperplasia patients with postoperative pathologic upgrade

Huang Wenyang¹, Zheng Xiaojuan², Jiang Ying¹, Wang Shuzhen¹

1. Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
2. Department of Gynecology and Obstetrics, Beijing Fangshan District Maternal and Child Health Hospital, Beijing 102488, China

Received:2019-09-23 Online:2019-11-21 Published:2019-12-18
Supported by:
This study was supported by Capital Citizen Health Cultivation Project(161100000116077),Key Projects of Sailing Plan of Beijing Medical Administration(ZYLX201713).

Abstract

Abstract: Objective To investigate high-risk factors and clinicopathological features associated with atypical hyperplasia(AH)patients with postoperative pathologic upgrade to endometrial cancer(ECa). Methods Clinicopathological data was obtained from 166 patients who underwent total hysterectomy for the treatment of AH (diagnosed by curettage) from January 2002 to December 2018 and were retrospectively analyzed. On the basis of the pathological evaluations post total hysterectomy,the patients were classified into two groups:ECa (74 cases) and AH (92 cases). The clinical features of the two groups were further analyzed to identify the high-risk factors responsible for the postoperative pathological upgrade to ECa. The pathologic features of patients was analyzed, who were diagnosed with AH by curettage but with postoperative pathologic upgrade to ECa after hysterectomy. Totally 325 patients diagnosed with ECa by curettage during the same period were set as the control. Results ECa was found in 74 of the 166 patients who underwent hysterectomy due to AH,with an incidence rate of 44.58%(74/166). Univariate analysis showed that advanced age,menopause,long-term abnormal bleeding,and endometrial thickening without hysteroscopy were high-risk factors associated with the postoperative pathological upgrade to ECa (P<0.05). Furthermore,advanced age,late menopause,endometrial thickening and long-term abnormal bleeding contributed mainly to the postoperative pathological upgrade to ECa, as suggested by multivariate analysis (P<0.05). All patients with postoperative pathological upgrade to ECa were endometrial adenocarcinoma,of which 91.89% (68/74) of the surgical pathological stages were stage Ia,and 74.32% (55/74) of the pathological grades were well differentiated. Conclusion ECa was found in 44.58% of patients with AH diagnosed by curettage,which led to pathological upgrade after hysterectomy. Advanced age,menopause,late menopause,long-term abnormal bleeding,premenopausal endometrial thickening, and postmenopausal curettage without hysteroscopy contributed to pathological upgrade to ECa. ECa found by postoperative pathological upgrade are usually endometrioid adenocarcinoma with high degree of tissue differentiation,early stage and good prognosis.

Key words: atypical endometrial dysplasia, endometrial cancer, diagnostic dilation and curettage

CLC Number:

R737.33

Huang Wenyang, Zheng Xiaojuan, Jiang Ying, Wang Shuzhen. Analysis of features of atypical hyperplasia patients with postoperative pathologic upgrade[J]. Journal of Capital Medical University, 2019, 40(6): 846-850.

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Analysis of features of atypical hyperplasia patients with postoperative pathologic upgrade

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