Recurrent endometrial hyperplasia without atypia in reproductive age. Prediction and early diagnosis

• Mekan R. Orazov
• Lyudmila M. Mikhaleva
• Irina A. Mullina

Abstract

The aim of the study was to identify risk factors for recurrent endometrial hyperplasia (EG) without atypia in women of reproductive age.

Material and methods. The study included 89 patients of reproductive age suffering from endometrial hyperplasia without atypia. During the study, two groups of women were formed depending on the course of EG: the main group (n=45) – women with recurrent endometrial hyperplasia without atypia (more than 2 episodes during the year), the comparison group – patients with newly diagnosed endometrial hyperplasia without atypia (n=44). The average age of the main group was 44±3.0 years, the comparison group – 42±2.0 years.

Results. The frequency of organic gynecological diseases, such as diffuse adenomyosis (OR= 5.067; 95% CI 1.786–14.373) and uterine leiomyoma (OR=3.938; 95% CI 1.501–10.328), was statistically significantly higher (by 3.3 and 1.2 times, respectively) in patients with recurrent endometrial hyperplasia without atypia (p<0.05).

It was found that patients with recurrent EG without atypia statistically significantly differ from patients with EG without recurrence in terms of risk of menstrual cycle disorders (OR=5.056; 95% CI 1.865–13.704) and obesity (OR=2.788; 95% CI: 1.152 – 6.750). The prevalence of benign breast dysplasia (OR=4.066; 95% CI: 1.593–10.378) was statistically significantly higher by 3.2 times in women with recurrent EG (without atypia) (p<0.05).

Conclusion. Risk factors for recurrent EG without atypia in women of reproductive age are: diffuse adenomyosis (OR=5.067; 95% CI 1.786–14.373), menstrual irregularity (OR=5.056; 95% CI: 1.865–13.704), benign breast dysplasia (OR=4.066; 95% CI 1.593–10.378), uterine leiomyoma (OR=3.938; 95% CI 1.501–10.328), obesity (OR=2.788; 95% CI 1.152–6.750).

Design: comparative prospective study.

Keywords:endometrial cancer; risk factors; endometrial hyperplasia; reproductive age

REFERENCES

1. MacLean J.A. 2nd, Hayashi K. Progesterone Actions and Resistance in Gynecological Disorders. Cells. 2022; 11 (4): 647. DOI: https://doi.org/10.3390/cells11040647 Epub 2022 Feb 13.

2. Orazov M.R., Khamoshina M.B., Mullina I.A., Artemenko Yu.S. Endometrial hyperplasia - from pathogenesis to effective therapy. Akusherstvo i ginekologiya novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2021; 9 (3): 21–8. DOI: https://doi.org/10.33029/2303-9698-2021-9-3-21-28 (in Russian)

3. Singh G., Puckett Y. Endometrial Hyperplasia. In: StatPearls. Treasure Island, FL: StatPearls Publishing, July 19, 2022.

4. Ring K.L., Mills A.M., Modesitt S.C. Endometrial hyperplasia. Obstet Gynecol. 2022; 140 (6): 1061–75. DOI: https://doi.org/10.1097/AOG.0000000000004989

5. Cho H.W., Ouh Y.T., Lee K.M., et al. Long-term effect of pregnancy-related factors on the development of endometrial neoplasia: a nationwide retrospective cohort study [published correction appears in PLoS One. 2019; 14 (4): e0215979]. PLoS One. 2019; 14 (3): e0214600. DOI: https://doi.org/10.1371/journal.pone.0214600 Epub 2019 Mar 28.

6. Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022; 72 (1): 7–33. DOI: https://doi.org/10.3322/caac.21708

7. Giannella L., Cerami L.B., Setti T., Bergamini E., Boselli F. Prediction of Endometrial hyperplasia and cancer among premenopausal women with abnormal uterine bleeding [published correction appears in Biomed Res Int. 2020; 2020: 3653414]. Biomed Res Int. 2019; 2019: 8598152. DOI: https://doi.org/10.1155/2019/8598152 Epub 2019 Mar 18.

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