Bilgin Tufan, Ozuysal Sema, Ozan Hakan, Atakan Türkan
Department of Obstetrics and Gynecology, Uludag University, Bursa, Turkey.
J Obstet Gynaecol Res. 2004 Jun;30(3):205-9. doi: 10.1111/j.1447-0756.2004.00178.x.
To investigate the possibility of coexisting endometrial cancer (EC) in patients with atypical endometrial hyperplasia (AEH).
Forty-six consecutive women who underwent hysterectomy for AEH were analyzed.
Final histopathological evaluation of hysterectomy specimens revealed EC in 11 patients (23.9%). Preoperative diagnosis of AEH was established by pipelle biopsy in eight patients and curettage was performed in the remaining patients. Of the patients with pipelle biopsy, two had a diagnosis of EC (25%), whereas nine women who underwent curettage, were further diagnosed as having EC (23.7%) (P > 0.05). Four (13.3%) of 30 women who had frozen sections at hysterectomy, were diagnosed with EC. Diagnosis of EC was missed in two patients (50%) at frozen section. In contrast, seven of 16 women (43.7%) who did not have frozen section, had EC.
A relatively high incidence of EC is seen in patients with a diagnosis of AEH. Diagnostic results of pipelle biopsy and curettage were comparable. Frozen sections of hysterectomy specimens does not guarantee to exclude the possibility of EC, especially in patients with no myometrial invasion.
探讨非典型子宫内膜增生（AEH）患者合并子宫内膜癌（EC）的可能性。
分析46例因AEH接受子宫切除术的连续女性患者。
子宫切除标本的最终组织病理学评估显示11例患者（23.9%）存在EC。8例患者通过子宫内膜吸取活检术前诊断为AEH，其余患者行刮宫术。在子宫内膜吸取活检的患者中，2例诊断为EC（25%），而9例行刮宫术的女性患者进一步诊断为EC（23.7%）（P>0.05）。30例子宫切除时行冰冻切片检查的女性患者中有4例（13.3%）诊断为EC。2例患者（50%）在冰冻切片时漏诊EC。相比之下，16例未行冰冻切片检查的女性患者中有7例（43.7%）存在EC。
诊断为AEH的患者中EC发生率相对较高。子宫内膜吸取活检和刮宫术的诊断结果相当。子宫切除标本的冰冻切片不能保证排除EC的可能性，尤其是在无肌层浸润的患者中。
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