Dordević Biljana, Stanojević Zorica, Zivković Vesna, Lalosević Dusan, Gligorijević Jasmina, Krstić Miljan
Medicinski fakultet, Nis, Institut za patologiju.
Med Pregl. 2007 Jul-Aug;60(7-8):372-6. doi: 10.2298/mpns0708372d.
The aim of this study was to analyze and compare the histopathological findings in curettage and hysterectomy specimens, to evaluate the accuracy of histopathological diagnosis in curettage specimens, and to determine the frequency of coexisting endometrial carcinoma in patients with histopathological diagnosis of endometrial hyperplasia.
Curettage and hysterectomy specimens of 135 female patients with initially diagnosed endometrial hyperplasia were retrospectively analyzed and compared.
Simple hyperplasia was found in 49 patients (36.3%), complex hyperplasia in 14 (10.4%), simple atypical hyperplasia in 24 (17.8%), and complex atypical hyperplasia in 48 (35.5%) patients. After hysterectomy, 59 (43.7%) patients were found to have simple hyperplasia, 12 (8.9%) complex hyperplasia, 15 (11.1%) simple atypical hyperplasia, 18 (20.7%) complex atypical hyperplasia, and 21 (15.5%) endometrial carcinoma. The accuracy of histopathological diagnosis of endometrial hyperplasia in curettage specimens was 82.2-89.6% and dependent on the types of hyperplasia. The frequency of coexisting endometrial carcinoma was significantly higher (p < 0.001) in patients with atypical hyperplasia than in patients with hyperplasia without cytological atypia. After hysterectomy, coexisting endometrial carcinoma was found in 27.8% of patients with histopathological diagnosis of atypical hyperplasia in curettage specimens. In contrast to simple atypical hyperplasia, the frequency of coexisting endometrial carcinoma was significantly higher (p < 0.05) in complex atypical hyperplasia.
The frequency of coexisting endometrial carcinoma in hysterectomy specimens in patients with histopathological diagnosis of atypical hyperplasia in curettage specimens was relatively high and it should be taken into account when planning therapy.
本研究旨在分析和比较刮宫术及子宫切除术标本的组织病理学结果，评估刮宫术标本中组织病理学诊断的准确性，并确定组织病理学诊断为子宫内膜增生的患者中共存子宫内膜癌的频率。
回顾性分析并比较了135例初诊为子宫内膜增生的女性患者的刮宫术及子宫切除术标本。
49例患者（36.3%）为单纯性增生，14例（10.4%）为复杂性增生，24例（17.8%）为单纯性不典型增生，48例（35.5%）为复杂性不典型增生。子宫切除术后，发现59例（43.7%）患者为单纯性增生，12例（8.9%）为复杂性增生，15例（11.1%）为单纯性不典型增生，18例（20.7%）为复杂性不典型增生，21例（15.5%）为子宫内膜癌。刮宫术标本中子宫内膜增生组织病理学诊断的准确性为82.2%-89.6%，且取决于增生类型。不典型增生患者中共存子宫内膜癌的频率显著高于（p<0.001）无细胞学不典型的增生患者。子宫切除术后，刮宫术标本组织病理学诊断为不典型增生的患者中27.8%存在共存子宫内膜癌。与单纯性不典型增生相比，复杂性不典型增生中共存子宫内膜癌的频率显著更高（p<0.05）。
刮宫术标本组织病理学诊断为不典型增生的患者子宫切除术后标本中共存子宫内膜癌的频率相对较高，在制定治疗方案时应予以考虑。
