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Спецвыпуск . 2024

Modern risk paradigm for atypical endometrial hyperplasia: predictive capabilities

Abstract

The aim was to summarize modern ideas about risk factors, clinical picture, possibilities of early diagnosis and personal prognosis of the risk of atypical endometrial hyperplasia.

Material and methods. An analytical review of scientific publications in scientometric databases (Pubmed, e-library) for the period since 2017 until 2023 was carried out.

Conclusion. A promising direction of scientific research is the development of methods for personalized prediction of the risk of developing AEH using a maximum of personal parameters, including anamnestic data, clinical manifestations, results of the use of imaging techniques, as well as assessment of the expression of IHC markers reflecting the proliferative potential of the tissue.

Keywords:atypical endometrial hyperplasia; diagnosis; biomarkers, prognosis

Funding. The study had no sponsor support.

Conflict of interest. The author declares no conflict of interest.

Contribution. Search for literature sources, concept and writing of the original text – Petrovskaya S.A., Khamoshina M.B., review of the text – Khamoshina M.B., Morozova K.V., finalization of the text – Khamoshina M.B., Morozova K.V., Hasan A.Sh.

For citation: Petrovskaya S.A., Khamoshina M.B., Hasan A.Sh., Morozova K.V., Soyunov M.A. Modern risk paradigm for atypical endometrial hyperplasia: predictive capabilities. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2024; 12. Supplement: 134–40. DOI: https://doi.org/10.33029/2303-9698-2024-12-suppl-134-140 (in Russian)

REFERENCES

1.Singh G, Puckett Y. Endometrial hyperplasia. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing, 2023 Jan. PMID: 32809528.

2.Radzinsky V.E., Orazov M.R., Khamoshina M.B., Mullina I.A., Artemenko Yu.S. «Vulnerable» endometrium: a modern view of the pathogenesis and pathogenetic therapy of endometrial hyperplastic processes. Reproduktivnaya meditsina [Reproductive Medicine]. 2021; 3 (48): 54–60. DOI: https://doi.org/10.37800/RM.3.2021.54-60 (in Russian)

3.Tolibova G.Kh., Tral’ T.G., Kogan I.Yu., Olina A.A. Endometrium. Atlas. Moscow: Redaktsiya zhurnala StatusPraesens, 2022: 184 p. (in Russian)

4.Artemenko Yu.S., Khamoshina M.B., Ryabova V.A., Zyukina Z.V. Obesity in women: current aspects of reproductive health. Meditsinskiy sovet [Medical Council]. 2022; 16 (5): 32–9. DOI: https://doi.org/10.21518/2079-701X-2022-16-5-32-39 (in Russian)

5.Kaprin A.D., Starinsky V.V., Shakhzadov A.O. Malignant neoplasms in Russia in 2021 (morbidity and mortality). Moscow: MNIOI im. P.A. Gertsena – filial FGBU «NMITs radiologii» Minzdrava Rossii, 2022. (in Russian)

6.Sobivchak M.S., Protasova A.E., Raskin G.A., et al. Malignant transformation of endometrial hyperplastic processes: immunohistochemical features. Opukholi zhenskoy reproduktivnoy sistemy [Tumors of the Female Reproductive System]. 2022; 18 (3): 89–99. DOI: 10.17650/1994-4098-2022-18-3-89-99 (in Russian)

7.World Obesity Atlas, 2023.

8.Andreeva E.N., Sheremet’eva E.V., Fursenko V.A. Obesity is a threat to Russia’s reproductive potential. Ozhirenie i metabolism [Obesity and Metabolism]. 2019; 16 (3): 20–8. DOI: https://doi.org/10.14341/omet10340 (in Russian)

9.Report, World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project. Food: nutrition, physical activity, and the prevention of endometrial cancer. 2018.

10.Kahn J.L., Buckingham L., Koelper N.C., Sammel M.D., Shah D.K. Risk factors for atypical hyperplasia and endometrial cancer in the infertility population: a case-control study. F S Rep. 2020; 2 (1): 104–8. DOI: https://doi.org/10.1016/j.xfre.2020.10.005 PMID: 34223280; PMCID: PMC8244272.

11.Hanley A.J., Bowden D., Wagenknecht L.E., Balasubramanyam A., Langfeld C., Saad M.F., et al. Associations of adiponectin with body fat distribution and insulin sensitivity in nondiabetic Hispanics and African-Americans. J Clin Endocrinol Metab. 2007; 92 (7): 2665–71. DOI: https://doi.org/10.1210/jc.2006-2614 Epub 2007 Apr 10. PMID: 17426091.

12.Wei S., Yi T., OuYang Z., Wu J. Association between ABO blood type and type I endometrial cancer: a retrospective study. J Obstet Gynaecol. 2023; 43 (1): 2153026. DOI: https://doi.org/10.1080/01443615.2022.2153026 PMID: 36606697.

13.Thoprasert P., Phaliwong P., Smanchat B., Prommas S., Bhamarapravatana K., Suwannarurk K. Endometrial thickness measurement as predictor of endometrial hyperplasia and cancer in perimenopausal uterine bleeding: cross-sectional study. Asian Pac J Cancer Prev. 2023; 24 (2): 693–9. DOI: https://doi.org/10.31557/APJCP.2023.24.2.693 PMID: 36853321; PMCID: PMC10162612.

14.Cong Q., Luo L., Fu Z., Lu J., Jiang W., Sui L. Histopathology of women with non-uniform endometrial echogenicity and risk factors for atypical endometrial hyperplasia and carcinoma. Am J Transl Res. 2021; 13 (5): 4500–9. PMID: 34150030; PMCID: PMC8205758.

15.Sjögren L.L., Morch L.S., Lokkegaard E. Hormone replacement therapy and the risk of endometrial cancer: a systematic review. Maturitas. 2016; 91: 25–35. DOI: https://doi.org/10.1016/j.maturitas.2016.05.013 Epub 2016 Jun 1. PMID: 27451318

16.Orazov M.R., Mikhaleva L.M., Mullina I.A. Prediction of recurrent endometrial hyperplasia. Trudniy patsient [Difficult Patient]. 2021; 19 (7): 6–8. DOI: https://doi.org/10.224412/2074-1005-2021-7-6-8 (in Russian)

17.Vetter M.H., Smith B., Benedict J., Hade E.M., Bixel K., Copeland L.J., et al. Preoperative predictors of endometrial cancer at time of hysterectomy for endometrial intraepithelial neoplasia or complex atypical hyperplasia. Am J Obstet Gynecol. 2020; 222 (1): 60.e1–7. DOI: https://doi.org/10.1016/j.ajog.2019.08.002 Epub 2019 Aug 8. PMID: 31401259; PMCID: PMC7201377.

18.Clinical recommendations of the Ministry of Health of the Russian Federation «Endometrial hyperplasia», 2021. (in Russian)

19.Auclair M.H., Yong P.J., Salvador S., Thurston J., Colgan T.T.J., Sebastianelli A. Guideline No. 392 – classification and management of endometrial hyperplasia. J Obstet Gynaecol Can. 2019; 41 (12): 1789–800. DOI: https://doi.org/10.1016/j.jogc.2019.03.025

20.Vitale S.G., Buzzaccarini G., Riemma G., Pacheco L.A., Di Spiezio Sardo A., Carugno J., et al. Endometrial biopsy: Indications, techniques and recommendations. An evidence-based guideline for clinical practice. J Gynecol Obstet Hum Reprod. 2023; 52 (6): 102588. DOI: https://doi.org/10.1016/j.jogoh.2023.102588 Epub 2023 Apr 13. PMID: 37061093.

21.Pandey J., Yonder S. Premalignant lesions of the endometrium. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing, 2023 Jan. PMID: 32965886.

22.Zhang G., Wang Y., Liang X.D., Zhou R., Sun X.L., Wang J.L., et al. Microscale endometrial sampling biopsy in detecting endometrial cancer and atypical hyperplasia in a population of 1551 women: a comparative study with hysteroscopic endometrial biopsy. Chin Med J (Engl). 2020; 134 (2): 193–9. DOI: https://doi.org/10.1097/CM9.0000000000001109 PMID: 33009021; PMCID: PMC7817330.

23.Wever B.M.M., van den Helder R., van Splunter A.P., van Gent M.D.J.M., Kasius J.C., Trum J.W., et al. DNA methylation testing for endometrial cancer detection in urine, cervicovaginal self-samples and cervical scrapes. Int J Cancer. 2023; 153 (2): 341–51. DOI: https://doi.org/10.1002/ijc.34504 Epub 2023 Mar 23. PMID: 36912267.

24.Masadah R., Maulana A., Nelwan B.J., Ghaznawie M., Miskad U.A., Tawali S., et al. Risk-stratification machine learning model using demographic factors, gynaecological symptoms and β-catenin for endometrial hyperplasia and carcinoma: a cross-sectional study. BMC Womens Health. 2023; 23 (1): 627. DOI: https://doi.org/10.1186/s12905-023-02790-6 PMID: 38008739; PMCID: PMC10680196.

25.Raffone A., Travaglino A., Saccone G., D’Alessandro P., Arduino B., Mascolo M., et al. Diabetes mellitus is associated with occult cancer in endometrial hyperplasia. Pathol Oncol Res. 2020; 26 (3): 1377–84. DOI: https://doi.org/10.1007/s12253-019-00684-3 Epub 2019 Jun 15. PMID: 31203571

26.Zhou X., Xu Y., Yin D., Zhao F., Hao Z., Zhong Y., et al. Type 2 diabetes mellitus facilitates endometrial hyperplasia progression by activating the proliferative function of mucin O-glycosylating enzyme GALNT2. Biomed Pharmacother. 2020; 131: 110764. DOI: https://doi.org/10.1016/j.biopha.2020.110764 Epub 2020 Oct 23. PMID: 33152927

27.Oncogynecology. National guide. In: A.D. Caprin, L.A. Ashrafyan, I.S. Stilidy (eds). Moscow: GEOTAR-Media, 2019: 384 p.: ill. (Series «National Guidelines»). DOI: https://doi.org/10.33029/9704-5329-2-ONR-2019-1-384 (in Russian)

28.Parrish M.L., Broaddus R.R., Gladden A.B. Mechanisms of mutant β-catenin in endometrial cancer progression. Front Oncol. 2022; 12: 1009345. DOI: https://doi.org/10.3389/fonc.2022.1009345 PMID: 36248967; PMCID: PMC9556987.

29.Travaglino A., Raffone A., Saccone G., De Luca C., Mollo A., Mascolo M., et al. Immunohistochemical nuclear expression of β-catenin as a surrogate of CTNNB1 exon 3 mutation in endometrial cancer. Am J Clin Pathol. 2019; 151 (5): 529–38. DOI: https://doi.org/10.1093/ajcp/aqy178 PMID: 30715091.

30.Colombo N., Creutzberg C., Amant F., et al. ESMO-ESGO-ESTRO Consensus Conference on endometrial cancer: diagnosis, treatment and follow-up. Ann Oncol. 2016; 27 (1): 16–41.

31.Grover S., Koh H., Weideman P., Quinn M.A. The effect of the menstrual cycle on serum CA 125 levels: a population study. Am J Obstet Gynecol. 1992; 167 (5): 1379–81. DOI: https://doi.org/10.1016/s0002-9378(11)91720-7 PMID: 1442994.

32.Lou Y., Liao J., Shan W., Xu Z., Chen X., Guan J. Menopausal status combined with serum CA125 level significantly predicted concurrent endometrial cancer in women diagnosed with atypical endometrial hyperplasia before surgery. Diagnostics (Basel). 2021; 12 (1): 6. DOI: https://doi.org/10.3390/diagnostics12010006 PMID: 35054175; PMCID: PMC8775082.

33.Zhu X., Liu L., Feng Z., Zhang Y. Correlation of plasma adipokines with endometrial atypical hyperplasia and type I/II endometrial cancer. J Obstet Gynaecol. 2023; 43 (1): 2179914. DOI: https://doi.org/10.1080/01443615.2023.2179914 PMID: 36815556.

34.Barnas E., Skret-Magierlo J., Skret A., Kaznowska E., Depciuch J., Szmuc K., et al. Simultaneous FTIR and Raman spectroscopy in endometrial atypical hyperplasia and cancer. Int J Mol Sci. 2020; 21 (14): 4828. DOI: https://doi.org/10.3390/ijms21144828 PMID: 32650484; PMCID: PMC7402178.

35.Bian P.P., Liu S.Y., Luo Q.P., Xiong Z.T. YTHDF2 is a novel diagnostic marker of endometrial adenocarcinoma and endometrial atypical hyperplasia/ intraepithelial neoplasia. Pathol Res Pract. 2022; 234: 153919. DOI: https://doi.org/10.1016/j.prp.2022.153919 Epub 2022 Apr 28. PMID: 35512522.

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

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