非典型复杂性增生的子宫内膜活检指导手术治疗的能力。

The ability of endometrial biopsies with atypical complex hyperplasia to guide surgical management.

作者信息

Miller Caela, Bidus Michael A, Pulcini Joseph P, Maxwell G Larry, Cosin Jonathan A, Rose G Scott

机构信息

Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, MD, USA.

出版信息

Am J Obstet Gynecol. 2008 Jul;199(1):69.e1-4. doi: 10.1016/j.ajog.2007.11.070. Epub 2008 Feb 1.

DOI:10.1016/j.ajog.2007.11.070

PMID:18241812

Abstract

OBJECTIVE

This study was undertaken to determine the clinical relevance of "qualifying comments" on pathology reports of complex atypical endometrial hyperplasia.

STUDY DESIGN

A retrospective review of endometrial biopsy specimens with atypical hyperplasia at our institutions was performed if subsequent hysterectomy results were available for review. Endometrial biopsy results were graded on an ordinal scale (complex atypical endometrial hyperplasia vs atypical endometrial hyperplasia "cannot rule out a more severe lesion") and compared with pathology obtained at hysterectomy. Data were analyzed by using Fisher's exact test.

RESULTS

Endometrial biopsy specimens were associated with carcinoma in 37.5% (18/48) of complex atypical endometrial hyperplasia cases and in 60% (18/30) of atypical endometrial hyperplasia-cancer cases. Atypical endometrial hyperplasia-cancer on biopsy was associated with an increased risk of discovering a malignancy at intermediate/high-risk for lymph node involvement (odds ratio 4.71, P = .0256).

CONCLUSION

Biopsy specimens that show atypical endometrial hyperplasia-cancer are associated with an increased risk of finding a cancer at intermediate or high risk for nodal metastasis.

摘要